Open To Work
Stephanie Baker
Rineyville,KY
Summary
Healthcare operations specialist with a strong focus on Medicare enrollment processing and claims resolution. Recognized for maintaining HIPAA compliance and ensuring data accuracy across multiple systems, contributing to streamlined workflows and improved operational efficiency in deadline-driven settings.
Overview
20
20
years of professional experience
Work History
Enrollment Representative (Medicare)
Humana
09.2025 - Current
- Processed high-volume Medicare Advantage (MA) and Part D (PDP) enrollments, prioritizing data accuracy and regulatory compliance
- Verified and updated sensitive member information across multiple systems to ensure data consistency and completeness
- Cross-referenced data from multiple sources to ensure enrollment accuracy and mitigate processing errors
- Review CMS reports and resolve discrepancies through timely corrections, additions, and updates
- Maintain strict HIPAA compliance while handling protected health information
- Meet productivity and quality benchmarks in a fast-paced, deadline-driven environment
Revenue Cycle Specialist
Centra Health
05.2022 - 08.2025
- Managed high-volume claims processing, including validation, correction, and resubmission of rejected claims
- Processed complex claims, including Workers' Compensation, by managing documentation and follow-up to secure timely resolutions
- Resolved discrepancies through documentation review and system analysis, ensuring accurate claims processing
- Collaborated with internal teams to streamline workflows, reducing potential processing delays
- Utilized multiple systems and reporting tools to track claims status, identify issues, and support resolution
- Maintained accurate, audit-ready records in compliance with payer guidelines and internal controls
Hero Care Network Specialist
American Red Cross
01.2022 - 04.2022
- Coordinated time-sensitive case management services for military families, ensuring effective emergency communication support
- Communicated with military personnel and organizations, facilitating timely and accurate case resolution
- Documented and tracked sensitive information, maintaining accuracy and confidentiality to uphold trust with military families
- Maintained compliance with strict organizational and privacy standards
College & Career Specialist
Cactus High School
Glendale
08.2020 - 05.2021
- Coordinated programs and opportunities through effective communication with students, families, and external partners
- Managed confidential student records and dual-enrollment processes to ensure compliance and support academic progress
- Organized accurate records to facilitate timely reporting and meet compliance requirements
- Created and distributed informational materials and updates
Various Roles
- Handled sensitive medical and legal information in compliance with HIPAA and organizational policies
- Executed high-volume data entry, documentation management, and recordkeeping to ensure accuracy and compliance across healthcare, legal, and administrative settings
- Delivered professional communication and customer support to enhance client satisfaction in fast-paced environments
- Developed skills in medical transcription, administrative support, and records management to improve operational efficiency.
Skills
- Insurance verification and enrollment processing
- Medical records management and documentation
- High-volume data entry and accuracy
- Claims processing and revenue cycle support
- Discrepancy resolution and problem solving
- HIPAA and CMS compliance
- Microsoft Office Suite proficiency
- EMR systems exposure: Cerner, FinThrive, Athena
- Multi-system navigation skills
- Time management and task prioritization
- Customer and team communication
- Eligibility Determination
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Enrollment Representative (Medicare)
Humana
09.2025 - Current
Revenue Cycle Specialist
Centra Health
05.2022 - 08.2025
Hero Care Network Specialist
American Red Cross
01.2022 - 04.2022
College & Career Specialist
Cactus High School
08.2020 - 05.2021