Contract Management Coordinator with Secret Clearance

Enthusiastic and hardworking detailed oriented individual with excellent multi-tasking and communication skills both oral and written with the ability to convey complex information clearly. My strong organizational and interpersonal abilities allow me to be a flexible, creative, dependable, team player and a fast learner that can meet deadlines and reach target goals. Ability to manage and prioritize multiple projects and tasks effectively.Strong understanding of insurance contracts, payor requirements, and healthcare regulations. Proficiency in using Google Drive, JIRA, Slack, and other relevant software tools.Detail-oriented with a focus on accuracy, compliance, and quality assurance. Strong problem-solving skills and the ability to work collaboratively with cross-functional teams.Ability to adapt to changing priorities and work in a fast-paced environment. SECRET CLEARANCE, Active June 2020 - Present EMPLOYMENT

Grow Therapy - Remote

June 2023 - Present

Coordinator - Contract Management Implementation

• Review, organize, and manage contracts to ensure compliance with insurance requirements and regulations.

• Provide regular updates on contract review statuses to relevant team members.

• Manage and respond to plan inquiries, confirming network inclusion and plan details, among other questions.

• Review and clarify contract language, ensuring accurate representation of agreements with payors.

• Maintain and update the Provider Manual Inventory, ensuring accessibility and accuracy of provider manuals for various payors.

• Communicate with insurance representatives to confirm details about plans and networks.

• Coordinate with internal teams to ensure accurate and timely information sharing regarding payor-related matters.

• Update and maintain payor contact lists, ensuring current and accurate information.

• Develop effective communication channels with payors to streamline operations and resolve any issues efficiently.

• Document and report on meetings and discussions related to insurance matters - for example, Medicaid requirements.

• Ensure that all relevant information is captured, organized, and accessible for future reference.

• Maintain comprehensive documentation of processes and procedures related to contract management and implementation.

• Participate in discussions and meetings to determine project direction and priorities.

• Manage tasks and follow up on action items to ensure project progression.

• Use project plans, timelines, and milestones to ensure successful implementation of initiatives.

• Document and distinguish between rate types, providing clarity for billing purposes.

• Regularly review and update rate information to ensure accuracy and compliance with payor agreements.

• Analyze rate structures and provide recommendations for improvements or adjustments as needed. SHADOWBOX CONSULTING, LLC – NAVAL HEALTH CLINIC QUANTICO May 2022- August 2022

Beneficiary Services Representative Physical Evaluation Board Liaison Officer (PEBLO)

• Physical Evaluation Board Liaison Officer for (MTF) Military Treatment Facility on Marine Corps Base Quantico, VA

• Provide Disability Evaluation System (DES) guidance with established DOD guidelines, data collection, Medical Evaluation Board (MEB) processing and Temporary Disability Retired List (TDRL)

• Reevaluations in accordance with applicable instructions, regulations, and directives

• Gather data from various sources, analyze data, statistical analysis, prepare statistical reports and recommendation for improvements

• Liaison Support provided to Active Duty and Reserve Component (RC) members and Commanders on program requirements, military benefits, legal right and the appeals process

• Coordinate Fitness for Duty determinations, Line of Duty (LOD) and other program requirements related to the DES

• Provide Physical Evaluation Board (PEB) findings to service members and medical staff

• Track each DES case from referral stage to final disposition

• Guide Service Members throughout the DES program

• Communicated with payors via email & telephone to verify coverage and assist with billing resolutions. LAREDO TECHNICAL SERVICES, INC. - NAVAL HEALTH CLINIC QUANTICO June 2020 – May 2022

Administrative Assistant to Physical Evaluation Board Liaison Officer (PEBLO)

• 1

st

point of contact for the Medical Evaluation Board (MEB) intake process

• Plan, organize, manage, and schedule functions for the Patient Administration staff within the MTF.

• Gather data from various sources, analyze data, statistical analysis, prepare statistical reports and recommendation for improvements.

• Maintained Spreadsheets on Excel and Google sheets to review and track statistics

• Responsible for effectively briefing and initiating members into the Integrated Disability System (IDES)

• Educate members on all the effective policies and procedures on the IDES process

• Train Physicians, Marine Commands and Naval Commands on how to use LIMDU Smart

• Educate members on forms needed for processing

• Council members on the importance of form completion deadline

• Coordinate & schedule with Legal Counsel (JAG) the completion of each members election forms

• Tact, diplomacy, and restraint in counseling and explaining entitlements, benefits, and responsibilities to all members.

• Responsible of ensuring that all pre-requisites for the initial IDES intake process are complete in a timely manner

• Utilize Electronic Medical Evaluation Board Reports (eMEBR) and LIMDU Smart (Limited Duty Sailor Marine Readiness Tracker) for data input, track and run reports on referred active and reserve component service members

• Accuracy of data entry is paramount to the accuracy of NHCQ’s (Naval Health Clinic Quantico’s) reports to higher authority

• Utilize CHCS, AHLTA, HAIMES and AMRDC safe and various other databases in support of the IDES process and the performance of other managerial task

• Request needed documents from physicians and commands

• Update members on their process

• Perform quality analysis of each members MEB records, ensure MEB record is properly prepared, dated, collated and hand MEB Record to designated assigned Physical Evaluation Board Liaison Officer

(PEBLO)

• Perform monthly tracking reports using Veterans Tracking Application (VTA) on boards processed through the MEB division to include numbers of Physical Evaluation Board (PEB), MEB, permanent disability retired list ( PDRL) evaluations, temporary disability retired list (TDRL) evaluations and temporary limited duty (TLD) evaluations

• Assist the Deployability Coordinator track TEMPO reports in monthly Comprehensive Deployability evaluation Boards (CDEB) and other BUMED assigned reports as directed by the Department Head • Keeping upper and lower echelon informed of members status MERCY DIAGNOSTICS

September 2017 – September 2018

Phlebotomist

• Obtain blood specimens by performing venipunctures from Pediatrics, Internal Medicine and Gastroenterology patients

• Process samples for appropriate storage and transport to the laboratory Enter patients demographics and insurance information into the laboratory information system along with laboratory orders

• Maintain specimen integrity by using aseptic technique, following department procedures

• Track collected specimens by initialing, dating, and noting time of collection; maintaining daily tallies of collections performed

• Perform clerical work such as, filing, calling insurance companies for procedure pre-authorizations and complete monthly inventory of laboratory supply

• Maintain a safe, secure and healthy work environment by following standards and procedures; complying with legal regulations including HIPAA.

GREENSBORO AURORA DIAGNOSTICS

December 2014 – March 2017

Phlebotomist

• Obtain blood specimens by performing venipunctures from Dermatology patients of all ages

• Process samples for appropriate storage and transport to the laboratory Enter patients demographics and insurance information into the laboratory information system along with laboratory orders

• Maintain specimen integrity by using aseptic technique, following department procedures

• Track collected specimens by initialing, dating, and noting time of collection; maintaining daily tallies of collections performed

• Perform clerical work such as, filing, calling insurance companies for procedure pre-authorizations and complete monthly inventory of laboratory supply

• Maintain safe, secure and healthy work environment by following standards and procedures; complying with legal regulations including HIPAA

EDUCATION

Allen Medical School of Science

Medical Assistant Certification 2007

Anne Arundel Community College

Phlebotomy Technician Certificate 2004

Associate in Early childhood Education 2003

LONG ISLAND CITY HIGH SCHOOL 1999 - 2002

Meade Senior HS Graduated January 2003

SKILLS

Spanish Bilingual fluent Excellent Organizational skills Dependable Adaptable to changes Great Team Player Red Cross CPR/BLS Certified Detail Oriented Strong administrative skills Strong credible provider relationships

Proficient with Microsoft Office Suite Programs, Presentation software (PowerPoint, Jira, Slack, Hubspot, Retool, keynote, Spreadsheets (Excel, Google Spreadsheets), Accounting software (QuickBooks)

REFERENCES AVAILABLE UPON REQUEST

Contact this candidate