Loan Processor Call Center
Resume:
Tanya Patterson
Houston, TX 77082
*************@*****.***
PROFESSIONAL SUMMARY
Enrollment and Credentialing Specialist with Revenue Cycle experience. Proficient with the revenue cycle process of third party medical billing and account reconciliation. Strong work ethic with the ability to multitask and work under pressure with high customer service standards.
SKILLS
Excellent organizational and analytical skills with strong workflow and daily productivity. Experienced in Epic, Remedy, NThrive, PECOS, Government Fee Schedules, CMS, CAQH, NCCI, NPPES, Onbase, Limited Configuration, ZoomGrants, CARES Act funding, SBA and Medical terminology. Training and mentoring skills include teamwork and conflict resolutions, KPI management and communication.
PROFESSIONAL EXPERIENCE
LCMC Health- New Orleans, LA
May 2021-Present
Senior Out of State Medicaid Hospital and Physician Enrollment Specialist
● Complete enrollment and revalidation tasks to new and existing providers/groups with government and contracted payers and provide financial and billing related support.
● Oversee the timely submission of enrollment applications and related documents.
● Follow up with the payers to ensure applications are being processed and creates and maintains CAQH profile and ensures contracted payers receive updated information; and facilitates provider re-attestations as required.
● Research problems and negotiate with internal/external customers, vendors to resolve moderately complex enrollment issues.
● Manage patient accounts to ensure they are billed appropriately after enrollment completes.
● Follow-up on claims pertaining to enrollment denials.
● Identify trends and implement methods to improve enrollment results. NDC (National Development Council)-Contract
June 2020-May 2021
Loan Processor
● Processed PPP loans/grants for businesses negatively affected and suffered economic hardship due to the business closure during the COVID-19 pandemic.
● Determined threshold eligibility review based on application screening questions.
● Complete federal eligibility check.
● Verify physical business location.
● Documented completed application questions and verified supporting documents while communicating with applicants.
● Worked other small grants retrieving necessary data to complete an application package and source essential documents for credit analysis of all qualified applicants.
● Submitted all applications to the underwriter to proceed or recommendation to decline. Rose International-Contract (CVS/Aetna Better Health Plan of LA) November 2019-May 2020
Provider Data Service Consultant
● Provided support for provider data transactions associated with projects, expansions, and new product implementations.
● Established, maintained, and aligned complex contracted provider demographic data and negotiated reimbursement arrangements across provider systems.
● Ensured providers and medical staff members maintain current credentials and licenses to work legally in their field or specialty.
● Monitored upcoming renewal dates and work with medical staff to advise them of the required steps to maintain their credentials.
Ochsner Health System – New Orleans, LA
June 2011 –October 2019
Senior Call Center Analyst II
● Collaborated with team members and conducted research and worked assigned special projects related to call center trends.
● Analyzed data to assist with department reporting and project planning on call center KPI.
● Organized data into reports and submitted presentations to management for monthly staff meetings.
● Trained representatives on appropriate calling techniques, phone scripts and customer service training.
● Delegated tasks, coached and offered additional development to team members.
● Researched and resolved complaints regarding customer service, registration, authorization, or scheduling for customers. Education
● Certified Medical Billing and Coding Eastern College of Health Vocations New Orleans, LA
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