Investigator Ii
Current
Nov 2024 - Present
AeroLeads people directory · profile
Eric Edwards Email & Phone Number
Investigator II | Ensuring Compliance with Healthcare Regulations | Increasing Operational Success.
at
Elevance Health
LinkedIn matched
✓ Verified Jul 2026
3 data sources
Profile completeness 86%
Current company
Role
Investigator II | Ensuring Compliance with Healthcare Regulations | Increasing Operational Success.
Location
Winston-Salem, North Carolina, United States
Who is Eric Edwards? Overview
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Quick answer
Eric Edwards is listed as Investigator II | Ensuring Compliance with Healthcare Regulations | Increasing Operational Success. at Elevance Health, based in Winston-Salem, North Carolina, United States. AeroLeads shows a matched LinkedIn profile for Eric Edwards.
Eric Edwards previously worked as Investigator II at Elevance Health and Call Center Manager at Carelonrx. Eric Edwards holds Bachelor Of Science - Bs, Networking And Communication Management, Magna Cum Laude from Devry University.
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Email format at Elevance Health
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Elevance Health
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Profile bio
About Eric Edwards
As a highly skilled Healthcare Investigator II, and a Military Veteran, I excel in ensuring compliance with healthcare regulations. My career has been marked by successful leadership, the development of efficient processes, and collaboration across departments, always with a focus on enhancing operational excellence.Key Expertise:✔ Facility and Professional Claims (UB-04 / CMS-1500): I swiftly review claims to verify payouts based on CMS and contracting guidelines, ensuring accurate disbursements.✔ Centers for Medicare & Medicaid Services (CMS Guidelines): Skilled in researching and applying CMS rules to confirm compliance for precise payouts.✔ Claim Analysis Based on Provider Contracting: Adept at reviewing provider contracts to increase payment accuracy.✔ Provider Claims Training Facilitation: I've facilitated training for new hires and provided refresher courses for associates on escalated claim issues and adjudication.✔ ICD-9 and ICD-10 Coding: My strong knowledge of CPT codes ensures billing accuracy and payment verification.✔ Medical Fraud, Waste, and Abuse Guidelines: I coordinate across departments to validate proper payments and identify improper billing practices.In my recent role at CarelonRx Pharmacy, I managed customer service operations for 25 associates, improving consumer satisfaction and reducing health risks. As a Customer Service Manager at Elevance Health, I led a team of 17 representatives, coordinated onboarding for new hires, and spearheaded initiatives that significantly reduced network errors.Previously, as an Operations Expert at Anthem, I optimized claim review efficiency and collaborated with the Special Investigations Unit on fraud, waste, and abuse issues. My proven track record includes providing expert guidance to teams and enhancing training processes to ensure operational continuity.I hold a Bachelor of Science (BS) in Networking and Communication Management from DeVry University, graduating magna cum laude. My professional development includes certifications and classes that reflect my commitment to excellence in healthcare operations.
Current workplace
Eric Edwards's current company
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4 roles · 13 years
Eric Edwards work experience
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Call Center Manager
Managed customer service operations for 25 associates, overseeing answering questions on status of medication delivery, enhancing consumer satisfaction, and reducing health risks. Took on customer grievances regarding prescription delivery resulting in increased productivity.Selected accomplishments• Due to my effective leadership, 9 out of 25 associates were promoted to different positions within just 8 months of their arrival.• Received Impact Award for successfully transforming the department's customer survey scores from failing to passing within 90 days of my arrival through effective coaching and team leadership.• Led the team to meet quality standards within 60 days, demonstrating strong leadership and training abilities
Jan 2024 - Sep 2024
Call Center Manager
Led team of 17 customer service representatives, providing leadership, training, and performance evaluations, driving operational success. Coordinated facility onboarding process for new hires, including setting up remote workstations and facilitating training sessions for classes of 18+ individuals per class,. Selected accomplishments:• Implemented the PC Hygiene process, reducing network errors by 60% for my team.• Streamlined the escalation process for IT Network errors, significantly reducing wait times for Tier 2 support for call center associates.
2019 - 2024
~5 yrs
Operations Expert
Served as primary point of contact for Medicaid provider claims, streamlining operations and enhancing provider satisfaction. Investigated escalated facility and professional claim issues for fraud, waste, and abuse, collaborating with Special Investigations Unit, reviewing improperly filed provider claims, and addressing provider inquiries. Facilitated refresher classes for newly trained claims associates who needed additional support, improving provider resolution and achieving lower call times.
2014 - 2019
~5 yrs
3 education records
Eric Edwards education
Bachelor Of Science - Bs, Networking And Communication Management, Magna Cum Laude
Course Work, Networking I Course, Gpa- 3.7
Coursework, Network Security Concepts Class, Gpa- 3.3
FAQ
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What company does Eric Edwards work for?
Eric Edwards works for Elevance Health.
What is Eric Edwards's role at Elevance Health?
Eric Edwards is listed as Investigator II | Ensuring Compliance with Healthcare Regulations | Increasing Operational Success. at Elevance Health.
Where is Eric Edwards based?
Eric Edwards is based in Winston-Salem, North Carolina, United States while working with Elevance Health.
What companies has Eric Edwards worked for?
Eric Edwards has worked for Elevance Health, Carelonrx, and Anthem, Inc..
How can I contact Eric Edwards?
You can use AeroLeads to view verified contact signals for Eric Edwards at Elevance Health, including work email, phone, and LinkedIn data when available.
What schools did Eric Edwards attend?
Eric Edwards holds Bachelor Of Science - Bs, Networking And Communication Management, Magna Cum Laude from Devry University.
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