SKILLS SUMMARY * Provider Relations and Liaison * Trainer, Presenter, Speaker * Medicaid, Medicare Advantage, Dual Eligible * Network Management, Development, and Recruitment collaboration with Regional Teams * P4P, PPO, POS, Managed Care, Medicaid, and Medicare contracting * Ancillary, Physician/Medical Group, and Facility contract administration * Complex issue resolution * HIPAA, NCQA, and CMS Compliance and contracting Regulations * Support Data Collection, Tracking, and reporting * ICD9 & ICD-10, CPT Coding, Medical Terminology * Claims AR Project Coordinator * Telecommute and field work 70% of work week * Account reconciliation and call center Supervisor

Highlights:

• AR
• Accounts Receivable
• Compliance
• Corrective Actions
• Field Work
• Financial Services
• Medicare
• Managed Care
• Healthcare Exchange
• Medicare Advantage
• Medicaid Managed Care
• Project Management
• Provider Contracting