TWANNA GAINES-ADAMS
Baltimore,US
Summary
Director of Procurement with 8+ years of experience in cybersecurity and healthcare sectors, adept at leading cross-functional teams and optimizing strategic sourcing initiatives. Demonstrates expertise in contract lifecycle management and vendor negotiations, ensuring compliance with industry standards. Actively pursuing advanced certification in medical coding and billing to enhance proficiency in healthcare operations.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Health & Benefits Claims Processor
Master Mates & Pilots
02.2025 - Current
- Processed and evaluated claims, ensuring compliance with company policies and industry regulations.
- Collaborated with internal teams to resolve discrepancies and expedite claim resolutions.
- Analyzed claim documentation for accuracy, identifying potential fraud or errors proactively.
- Streamlined workflows by implementing best practices in claims processing procedures.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Managed workload and priorities to meet claims processing meet deadlines.
DIRECTOR OF PROCUREMENT
JustOne Solutions, LLC
01.2022 - 01.2025
- Direct procurement for cybersecurity, achieving measurable cost reductions.
- Negotiate vendor contracts, securing favorable terms and enhancing partnerships.
- Align procurement policies with cybersecurity standards, ensuring compliance.
- Collaborate with technical teams to meet security specifications in procurement.
- Lead cross-functional evaluations, selecting effective security solutions.
- Spearheaded strategic sourcing initiatives, optimising cost efficiency while ensuring alignment with cybersecurity compliance requirements.
DISCHARGE LIAISON
MedCare Equipment Company
03.2019 - 11.2021
- Coordinated patient discharge processes and medical equipment requirements using EPIC and BriTree systems
- Managed communication between healthcare providers, patients, and equipment suppliers
- Ensured compliance with healthcare regulations and insurance requirements
- Optimized discharge procedures to improve patient satisfaction and reduce delays
- Maintained detailed documentation of equipment orders and patient requirements in EMR/EHR systems
- Utilized PC ACE software for claims processing and documentation
LEAD CSA MEDICAL BILLING AND COLLECTIONS
Peerless Credit & Debt Management Services
05.2018 - 03.2019
- Supervised medical collections team and billing operations
- Managed complex billing scenarios and insurance claim resolutions through multiple platforms
- Developed training programs for new customer service representatives
- Implemented process improvements to increase collection efficiency
- Maintained strict HIPAA compliance in all billing and collections processes
PRIOR AUTHORIZATION REP (CONTRACT)
Novitas Solutions (Medicare)
10.2017 - 05.2018
- Processed and evaluated Medicare Part A and B prior authorization requests, ensuring compliance with CMS guidelines and medical necessity criteria
- Reviewed clinical documentation for medical necessity determination according to Medicare LCD and NCD policies
- Coordinated with healthcare providers to obtain additional documentation necessary for authorization decisions
- Managed high-volume authorization requests while maintaining strict adherence to turnaround time requirements
- Utilized Medicare systems (PC ACE, FISS) to process authorizations and maintain accurate documentation
- Conducted thorough medical reviews of inpatient, outpatient, and DME authorization requests
- Maintained current knowledge of Medicare policies, procedures, and regulatory updates
CONTRACT ANALYST (TEMP)
American Personnel Managers & Consultants, INC
01.2017 - 07.2017
- Utilized SAM.gov and other platforms to capture $50M+ in diverse contract opportunities.
- Achieved an 85% response rate while managing over 25 concurrent solicitations.
- Drafted, reviewed, and negotiated contractual agreements to mitigate risks.
- Analyzed contract terms and conditions to ensure compliance with legal requirements.
- Maintained accurate records of contracts and amendments for audit readiness.
- Led initiatives to enhance efficiency in contract processing workflows.
- Established performance metrics to monitor contract progress, enabling timely intervention when needed.
CUSTOMER SERVICE REP
CMD
02.2014 - 12.2016
- Assisted customers with inquiries, enhancing satisfaction and retention through effective solutions.
- Consistently exceeded performance targets, handling a high volume of inquiries efficiently. Recognized for outstanding problem-solving skills and ability to defuse tense situations.
- Provided empathetic support during peak complaint periods, de-escalating tense situations effectively. Consistently received positive feedback from satisfied customers.
- Fostered positive client relationships through empathetic communication. Mentored new team members, enhancing overall department performance and cohesion.
FACILITY MANAGER
Gracious Living of Reisterstown, Llc
08.2012 - 02.2014
- Managed medication and phlebotomy tasks, ensuring safety compliance.
- Enhanced efficiency and patient care through process improvements.
- Resolved medication discrepancies, boosting accuracy and safety.
- Integrated advanced protocols, significantly reducing medication errors.
- Contributed to a safer environment with diligent oversight.
Education
Certificate Of Technical Studies - Medical Biller And Coder
AAPC
Salt Lake City, UTCertificate Of Technical Studies - CNA/GNA
Health Focus
Baltimore, MDSkills
- Healthcare Operations Management
- Contract Analysis & Negotiation
- Claims Processing & Revenue Cycle Management
- Procurement & Vendor Management
- Regulatory Compliance & Quality Assurance
- Data Analysis & Process Improvement
- Customer Service Excellence
- Financial Management & Budget Oversight
- Leadership & Team Management
- Technology Proficiency
- Communication & Stakeholder Relations
- Critical Thinking & Problem Solving
Certification
- BASIC LIFE SUPPORT - Red Cross May 2024 - May 2026
- JAMF CERTIFIED ASSOCIATE
- CCT CERTIFIED CYBERSECURITY TECHNICIAN
- FOUNDATION OF PROJECT MANAGEMENT
Work Type
Contract WorkFull TimePart TimeGig WorkWork Location
RemoteHybridOn-SiteTimeline
Health & Benefits Claims Processor
Master Mates & Pilots
02.2025 - Current
DIRECTOR OF PROCUREMENT
JustOne Solutions, LLC
01.2022 - 01.2025
DISCHARGE LIAISON
MedCare Equipment Company
03.2019 - 11.2021
LEAD CSA MEDICAL BILLING AND COLLECTIONS
Peerless Credit & Debt Management Services
05.2018 - 03.2019
PRIOR AUTHORIZATION REP (CONTRACT)
Novitas Solutions (Medicare)
10.2017 - 05.2018
CONTRACT ANALYST (TEMP)
American Personnel Managers & Consultants, INC
01.2017 - 07.2017
CUSTOMER SERVICE REP
CMD
02.2014 - 12.2016
FACILITY MANAGER
Gracious Living of Reisterstown, Llc
08.2012 - 02.2014
Certificate Of Technical Studies - Medical Biller And Coder
AAPC
Certificate Of Technical Studies - CNA/GNA
Health Focus
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