Entry Level Service Representative
Resume:
Rosalind Willis
Garfield Hts., Ohio 44125
email:ad15cg@r.postjobfree.com
To Whom It May Concern:
This letter is a brief indication of my goals and experience in the growing industry of Healthcare. I have 25 years of extensive experience in this industry, growing from entry level to managerial level positions. I have designed and implemented systems along with operational processes for workflow projects. In each assignment, I have prided myself on being detailed oriented, highly motivated, skillful problem solving and a self-starter with excellent 8organizational skills.
I am interested in continuing my professional development with a progressive organization that can fully utilize my skills and expertise. If your organization can benefit from a productive and conscientious leader who insists on quality results, then I would welcome the opportunity to present my credentials and myself in person. I look forward to your response, and to the opportunity to discuss a professional affiliation.
Sincerely,
Rosalind Willis
Rosalind Willis
13615 Cranwood Park Blvd
Garfield Hts., Ohio 44125
email:ad15cg@r.postjobfree.com
EDUCATION
April 2006 Masters of Business Management, Indiana Wesleyan University
May 2002 Bachelors of Business Administration, Tiffin University
June 1996 Associates of Applied Sciences. Cuyahoga Community College
EXPERIENCE
2022 – 2023. Lead Medical Billing Specialist, Life Solutions South LLC.
Recruit Mental and Substance Abuse providers to utilize Credentialing and Billing services.
Setup patient profile with demographic, diagnosis and payor information in Billing system.
Submit and resumbit claims via electronic and/or hardcopy via Clearinghouse and/or payor portals. Work with Customer Service and/or Provider Relations.
Analyze and track providers patient cost, quality of care, access and performance reports.
Research and investigate new medical policies and Billing.
Develop and conduct training sessions for internal staff and providers.
2019 – 2020 Provider Service Representative, Kellison & Company
Recruit physicians to utilize Credentialing & Billing service
Evaluate applications and negotiate contracts for physicians
Maintain and manage Credentialing and Recredentialing for the physicians
Analyze and track provider cost, quality, patient access and service performance reports.
Provide recommendation and strategic data to help achieve aggressive discounts.
Prepare and analyze monthly financial reports for physicians
Design, develop and conduct training seminars for internal staff and physicians
2009 – 2019 Senior Network Account Manager, United Healthcare Network Management (Cleveland)
Recruit ancillary, physicians and hospitals to join the network
Evaluate applications and negotiate contracts for Commercial, Medicare and Medicaid
Maintain and manage Credentialing and Recredentialing for ancillary providers
Develop strategies to meet UCRT targets and matrix for UHN
Research and prepare data for financial analyst to negotiate contracts
Develop and build relationships with providers
Research and resolve issues for network providers
Conduct provider education and training orientations for network providers
2008– 2009 Network Development Specialists, WellCare of Ohio
Recruit physicians and ancillary providers, evaluate applications and negotiate contracts for Market expansion
Develop strategies to target designed markets and specific specialties
Maintain and manage Credentialing and Recredentialing for network
Analyze provider cost, quality, access and service performance reports.
Develop and implement new policy and procedures
Develop, design and conduct training seminars and workshops
2007 – 2010 Provider Service Representative, Kellison & Company
Recruit physicians to utilize Credentialing & Billing service
Evaluate applications and negotiate contracts for physicians
Maintain and manage Credentialing and Recredentialing for the physicians
Analyze and track provider cost, quality, patient access and service performance reports.
Provide recommendation and strategic data to help achieve aggressive discounts.
Prepare and analyze monthly financial reports for physicians
Design, develop and conduct training seminars for internal staff and physicians
Rosalind Willis
13615 Cranwood Park Blvd
Garfield Hts., Ohio 44125
email:ad15cg@r.postjobfree.com
2001– 2007 Senior Ancillary Contracting Specialist, Medical Mutual of Ohio.
Recruit physicians, evaluate applications and negotiate contracts for Ancillary network
Maintain and manage Credentialing and Recredentialing for the Ancillary provider network
Analyze provider cost, quality, access and service performance reports.
Provide recommendation and strategic data to help achieve aggressive discounts.
Develop and implement new policy and procedures
Prepare RFP’s for Underwriting, Actuarial and Marketing
Formulated and implemented provider orientation manuals and Ancillary newsletters
Develop, design and conduct training seminars and workshops
2000 – 2001 Ancillary Contracting Specialist, Medical Mutual of Ohio
Recruit physicians, evaluate applications and negotiate contracts for hospital-based ancillaries.
Maintain and manage Credentialing and Recredentialing for network hospitals
Prepared hospital amendments, contracts and rate maintenance for Director and RNA’s
Support RNA’s with researching and resolving issues for network hospitals.
Researched and prepared data for RNA’s financial analyst to negotiate hospital contracts
1999 - 2000 Patient Registration Representative, The Cleveland Clinic Foundation
Register patients for surgery
Prepare and gather charts for surgeon’s review
Facilitate patients to next appointment within CCF
Prepare and adjust patient schedules
1997 – 1999 Credentialing Coordinator, Cleveland Health Network (CCF MCO)
Maintain and manage Credentialing and Recredenitaling for the MCO health system physician network
Maintain physician demographic database
Prepare reports for Credentialing committee
Performed and verified primary source information utilizing NPDB, Ohio Medical
License Boards and other various websites
Support Provider Relations Reps for assigned region
Rosalind Willis
13615 Cranwood Park Blvd
Garfield Hts., Ohio 44125
email:ad15cg@r.postjobfree.com
1997 – 1999 Office Manager, Syed J. Ali, MD, Chief of Vascular Surgery (UHHS)
Schedule patients for surgery
Post payor and patient payments
Maintain patient accounts
Prepared payor applications for network status
Prepare health presentation for physician
Trained, supervised and evaluated office staff
1996 – 1997 GPS Coordinator, Provider Relations, Prudential Healthcare Group
Maintain and manage Credentialing and Recredenitaling for physician network
Maintain physician demographic database
Prepare reports for Credentialing committee
Performed and verified primary source information utilizing NPDB, Ohio Medical
License Boards, and other various websites
Support Provider Relations Reps for assigned region
Coordinate systems training for Prudential systems
SKILLS
Proficient in using Microsoft Office Products (Word, Excel, Access and PowerPoint), DB2, SAS, Crystal Reports, NDB, Facets, COSMOS, Emptoris, Goldmine, DB2, 10-key, ICD-9 and HCPCS Coding, Medical Terminology and Accounting Principles, Emptoris, Lotus Notes and Navigator.
VOLUNTEER WORK
2005 City Year Champion Volunteer Work
Women’s Shelter
Junior Achievement
Voter Registration
H. Barbara Booker tutor
Bedford City School tutor
REFERENCES UPON REQUEST
Contact this candidate