Account Manager Client Services
Resume:
Martha (Ann) Showers
Houston, TX
**********@*****.***
Professional Summary
Responsible for supporting testing activities related to Healthplan systems, ensuring that applications and tools meet functional and non-functional requirements. Many years Market segments, Medicare, Medicare, Exchange, Commercial, Rx, OTC and SNF experience, Claims, Compliance, CMS, work closely with business analysts, developers, product owners, and stakeholders to understand requirements and translate them into test scenarios, Kanban team, Scrums, Product implementation, Retention, Cross functional collaboration, HEDIS, CAHPS, NCQA and Accreditation experience, test environments, medical billing, claims, excellent verbal and written communication skills, formulating reports, AEP, TPAs and Vendors
Work History
Account Manager 01/2024- 6/2024
WellCare
Client Services, Client facing and Conflict resolution
TPA meetings
Tracking/Monitoring all stages of client’s accounts
Claims
Tracking client issues throughout lifecycles
Account Manager 11/2022 – 03/2023
HealthAxis Group
Client Services, Client facing and Conflict resolution
Deliver on client requests, solutions and resolving issues
Ensure comprehensive test coverage of functional, regression, integration, and performance scenarios
Scrum Team and Kanban Team
Manage CR/DR
Contract knowledge
Analyst 11/2020- 1/2021-Temp.
Aetna /CVS
Analyze healthcare data (claims, clinical data, patient demographics, provider data) to identify trends, patterns, and opportunities for improvement.
Collaborate with IT and data teams to ensure effective integration and utilization of healthcare data across various platforms and systems.
Claims
Reports
HEDIS data
Remote experience
Account Manager 1/2018 – 2/2020(Covid-19)
Cigna Healthcare
Client facing, solutions and resolving issues
Contracts and Fee schedules to price
Tracking/Monitoring all stages of client’s accounts
Claims
Tracking client issues throughout lifecycles
Account Manager 1/2015 – 12/2017-Temp.
WellCare Healthcare
Provider relations training/education
Reports and Over reading
HEDIS data abstraction
CAHPS, NCQA and CMS
Customer Service
SNF and OTC
Education
U of H Downtown
Computer and Information Sciences 8/2022 - Current
Houston, TX
University of Phoenix
Business Administration
Tomball Sr. High Tomball, TX
High School Diploma
Technical Skills
Microsoft Office, Excel, Word Outlook, Power-Point, Internet Explorer, Meditech, HaxComm/Health-Pro, Advantmed, Availity, Teams, Touch Point, Macess, Cisco and IDX, SAP CATS
Proficient in use of basic office machines, audiovisual equipment, EMR systems, Epic, laser printers, Pivot tables, fax machines, high-speed copiers, digital scanners, etc.
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