SUMMARY

• I "ve been working as a Customer Service Representative for a well know Health Care Company for over 10 years. I have solid understanding of the Health Care and Medicaid Programs and would be able to bring that experience to a new position.

TECHNICAL SKILLS

• Microsoft Office Professional: MS DOS 3.2 - 6.2 • 3270 Mainframe Workspace • Windows 7 & 8 / XP / NT
• 4.0Windows Server 2003 • Ethernet • LANE / WAN • TCP / IP • DHCP • DNS • Active Directory • Dell • Compaq •
• HP •Mac. Excel 2016, OneNote MCSE 20032016, Outlook 2016, PowerPoint 2016, & Word.

PROFESSIONAL EXPERIENCE

Provider Help Desk

Confidential

Responsibilities:

• Develops and maintains a computerized provider database which includes physician training and retraining datesenrollment status and related data, addresses, additional physicians practicing at the site, etc.;
• Maintains and processes all Unit correspondence including recruitment efforts (i.e., maintaining the provider filestracking recruitment efforts, mailing and/or faxing recruitment materials, sending letters to accepted providers) and all ther correspondence for the Unit as needed;
• Reviews field reports and makes recommendations to the Provider Services Supervisor if further action is required;
• Interacts daily with the Provider Services Representatives and follows-up on their requests for provider enrollment information and other Project related issues;
• Acts as a help desk resource to providers, administrative staff and field staff, to ensure quality customer service and optimize Healthy Kids access and reimbursement;
• Develops, maintains and updates all documents regarding PCP enrollment including applications, enrollment and certification documents, address code requests, withdrawals, all practice status changes, etc.; processes and tracks enrollment forms; communicates PCP enrollment data to HFS;
• Provides proactive customer service to providers and facilities throughout the state through inbound and outbound calls via the provider helpline;
• Participates in the field staff meetings and other training; assists with the planning and logistics including preparation f materials, travel arrangements, and related duties;
• Responds to provider inquiries; researches and resolves problems related to enrollment and payment issues;
• Ensures that referral information is available to providers on real-time basis, so providers can check to see if a referral has been made;
• Suggests topic areas and assists in the development of provider educational materials, as appropriate; and Performs these and all other duties for the Provider Services Unit as assigned.
• Initiated two key partnerships which resulted in 54% revenue growth.