Tonya Malone
Indianapolis,Indiana
Summary
Organized and responsible professional with more than 20 years’ experience across diverse industries. A quick learner with exceptional interpersonal skills and the unique ability to manage several tasks in a stressful environment.
Overview
28
28
years of professional experience
Work History
Provider Relations Specialist
MDwise
02.2021 - Current
- Facilitated provider onboarding processes to enhance network participation and streamline operations.
- Conducted training sessions for providers on compliance, policies, and system usage to ensure effective engagement.
- Collaborated with cross-functional teams to resolve provider issues, improving overall satisfaction and communication efficiency.
- Analyzed provider feedback data to identify trends and implement strategic improvements in service delivery.
Customer Service Specialist
MDwise Inc.
07.2015 - Current
- Answers incoming healthcare insurance calls from members and providers in the healthcare industry
- Utilizes web-based applications to assist members and providers
- Provides healthcare providers with claim status, member’s benefits, and other related questions
- Research and resolve inquiries from healthcare provider and members
- Emails and/or fax correspondence, explanation of benefits, remittance advices and summary of benefits to members and/or providers upon request in compliance with HIPPA rules and regulations.
- New hire training
- Assist with Provider Relations
- Specialist enrollment via Provider Intake Tool
- Indexing
- Knowledge of systems such as Cacutus, Vivantio, Provider Intake Tool, Wit (SQL Search Tool), and Indiana Medicaid Portal (Core).
Customer Service Representative
Fast Track Student Loans
01.2013 - 01.2015
- Counseled delinquent customers on all available repayment and deferment options to resolve the customer's delinquent status
- Answered incoming calls to clients regarding their student loans
- Processed payments on outstanding accounts from students.
- Managed accounts for sales representatives
Customer Service Representative
AT&T
01.2008 - 01.2013
- Answered telephone inquiries from clients and customers regarding their accounts, services, products, and equipment
- Made outgoings call to potential clients for AT&T service
- Provided technical support for trouble shooting issues on customer’s devices and services
- Utilized operational systems to process purchases of AT&T products and services; i.e. collections, payments for Wireless bills and accessories
- Maintained working knowledge of all company products, services and promotions
Dietary Clerk
Westview Hospital
01.1998 - 01.2008
- Created new diets and menus for patients based on dietary needs
- Processed patient orders for food preferences, menu compliance and dietary restrictions.
- Assisted in food preparation, sanitation, and maintenance for the kitchen staff
- Supervised weekend shift employees for preparing menus and diets for patients based on patient requirements
Education
High School Diploma -
Ben Davis High School
01.1986
Skills
- Data Entry
- Correspondence
- Customer Relations and Support
- Account Management
- Scheduling
- Healthcare Provider Credentialing
- Customer Service
- Inbound/Outbound Calls
- Quality Assurance
Timeline
Provider Relations Specialist
MDwise
02.2021 - Current
Customer Service Specialist
MDwise Inc.
07.2015 - Current
Customer Service Representative
Fast Track Student Loans
01.2013 - 01.2015
Customer Service Representative
AT&T
01.2008 - 01.2013
Dietary Clerk
Westview Hospital
01.1998 - 01.2008
High School Diploma -
Ben Davis High School
COMPUTER EXPERIENCE
Microsoft Word, Outlook, PowerPoint and Excel 2010; Windows, Web Interchange, Internet Explorer, Interaction Client Software