Human Resources Customer Service
Resume:
ZHANNA HALL
**** ***** **** ***** ~ Riverdale, Georgia 30296
334-***-**** ~ **********@*****.***
OVERVIEW OF QUALIFICATIONS
Administrative professional with an extensive background in the coordination of human resources operations.
Skilled in the administration of employee benefits, as well as the tracking of staff training and development programs, performance evaluations and on-boarding procedures.
Well-versed in accounting and bookkeeping procedures, as well as auditing and statistical data reporting
QNXT, CCMS, Facets, On Base, Citrix, ECHO Systems, Adobe8, Microsoft Office (Word, Excel, PowerPoint, Publisher, Access, Outlook) Outstanding customer service skills, receiving recognition for building and maintaining strong professional relationships with clientele.
OUTSTANDING PROFESSIONAL ACCOMPLISHMENTS
Promoted to team leader after providing superior service as a medical biller.
Recognized by management team at Sprint for outstanding performance in sales and services during inbound calls.
As a Supply Analyst with the United States Army National Guard, ensured supplies were in A compliance with OSHA.
ACADEMIC BACKGROUND
TROY UNIVERSITY, Troy, Alabama
Master of Business Administration, Human Resources, 2015
Bachelor of Business Management (Counseling Minor), 2013
EMPLOYMENT HISTORY
Cigna Healthsprings, Montgomery, Alabama 11/15-present
Senior Provider Relations
Manage day to day contracting operations for Blue Shield of California.
Support attainment of department goals under the leadership of the Director of Provider Contracting and/or Provider Contracting Manager and ensure alignment of these goals with the company’s strategic priorities
Support review and modification of contracting and cost of health care savings strategies in anticipation of, and in response to, shifts in provider and competitor negotiating approaches
Research opportunities within the assigned local market (i.e., network expansion opportunities, utilization or unit cost excesses, etc.) and assess market trends to drive initiatives which enhance company's market position
Supports the development, negotiation, implementation, and maintenance of a comprehensive provider network. This includes supporting the development of payment policies, alternative payment methodologies, fee schedules, provider communications, and retention strategies, as well as the management of online directories.
Continually review and modify contracting documents and support work that derives cost of health care savings strategies in anticipation of, and in response to, shifts in provider negotiating approaches
Supports attainment of department goals under the leadership of the Director and ensures alignment of these goals with Blue Shield's strategic priorities.
Supports, review, and modification of contracting and cost of health care savings strategies in anticipation of, and in response to, shifts in provider and competitor negotiating approaches.
Partners with other team members to meet member and provider service requirements, including identification of network gaps, development and oversight of corrective actions and ongoing management of process improvements. Also identifies service issues across departments, develops process improvements, modifications, and enhancements, and maintains ongoing cross-functional communications.
Physiotherapy Associates, Birmingham, AL 08/10-10/15
Provider Specialist
Designated S.M.E. for provider demographic loading into systems such as HSD Tables, claims, and directory.
QNXT Provider Data Management and Support.
QNXT, Provider Management - Enrollment, Credentialing, Network & Contracts, Configuration, Written Communication, Verbal Communication
QNXT, Provider Management - Enrollment, Credentialing, Network & Contracts, Configuration, Written Communication, Verbal Communication
Oversaw the gathering of information from provider outreach, vendor feedback, various health providers, and market research while ensuring the timely drafting of demographic data to multiple computerized filing systems. Nurtured provider relations to help support and encourage strategic growth in the local market.
Implemented compliance of provider data to C.M.S. regulations; proficient with the application of relevant department policies or procedures, Medicare, and HIPPA to safeguard patient medical information.
Provided empathetic customer service to valued clients, coordinators, healthcare providers, insurance community, and specialists; facilitated the accurate verification of information and inquiries, through an extensive explanation of processes as well as company policies relating to various healthcare products, benefits, and services.
Received, reviewed, and authorized requests from hospitals, providers, and vendors based on member or provider status using C.P.T. or ICD-10 coding; negotiated, administered, as well as executed contracts with its schedule of fees.
ZHANNA HALL Page Two
EMPLOYMENT HISTORY
(Continued)
Sprint Sales, Montgomery, Alabama 8/09-7/10
Recruiter
Consulting employers about hiring needs
Interviewing applicants and vetting them for the position
Doing background checks and calling references
Explaining the benefits, company policies and parameters of the job to applicants
Hiring the most qualified applicant
Onboarding new hires and assisting with orientation
Processing hiring paperwork and maintaining employee records
UNITED STATES ARMY NATIONAL GUARD, Montgomery, Alabama 6/04 – 7/09
Supply Specialist/Technical Assistant
Served domestically in Montgomery and abroad in Afghanistan.
Supervised 12-person platoon, coordinating inventory monitoring and ordering of land and air support systems.
Conducted account and supply bookkeeping, auditing and maintenance.
Provided technical support to Logistics Company on SBSS and Connage Integrated systems, along with integrated logistics system that ensure all data was compiled for accurate reporting.
Used Excel to generate reports that were distributed to management personnel, officers, and civilian employees for the purchasing and trade of government material.
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