Provider Data Specialist II (Part-Time)

Alice Williams

Fort Worth, TX • 682-***-**** • ***************@*****.***

Professional Summary

Detail-oriented Provider Data Specialist II with 10+ years of healthcare experience. Skilled in provider data management, auditing, and compliance, with a strong focus on accuracy and efficiency. Proven ability to streamline processes, resolve data issues, and support cross-functional teams.

Core Skills

Provider Data Management • Claims Processing • Credentialing • HIPAA Compliance Data Entry & Auditing • CPT Coding • Medical Terminology Microsoft Office (Excel, Word, Access) • Reporting & Analysis Customer Service • Process Improvement

Work Experience

Provider Data Specialist II – CHRISTUS Health (Aug 2019 – Present) Maintain and audit provider data to ensure accuracy and compliance Identify and resolve data discrepancies

Streamline data entry processes

Collaborate with internal teams

Handle high-volume records under deadlines

Billing and Coding Representative – MEDNAX (Mar 2018 – Aug 2019) Submitted accurate claims and ensured compliance

Resolved billing and coding discrepancies

Monitored denied claims

Assisted patients with billing inquiries

Insurance Specialist II – US Oncology Network (Jan 2015 – Mar 2018) Processed claims and policy updates

Resolved insurance issues

Ensured regulatory compliance

Appeals Representative II – UnitedHealthcare (Apr 2013 – Jan 2015) Reviewed denied claims

Managed high-volume caseloads

Collaborated with providers and insurers

Operations Specialist II – Comerica Bank Wealth Management (Feb 2009 – Nov 2012) Monitored transactions and reduced errors

Generated operational reports

Ensured compliance with controls

Education

High School Diploma – Hillcrest High School, Dallas, TX