Adriana Cuellar Email & Phone Number

• Managed Epic Enterprise Data Warehouse reports, optimizing task distribution for team efficiency
• Processed and resolved claims with missing codes, ensuring accuracy and timely adjudication
• Contributed to configuration and troubleshooting of Epic Tapestry module for seamless system operation
• Collaborated with cross-functional teams to address complex issues and ensure system integrity.

• Negotiated and executed provider contracts, fostering positive relationships and ensuring contractual compliance
• Oversaw provider credentialing processes, ensuring accurate and up-to-date data in EPIC
• Managed contract negotiation and execution processes for various lines of business, ensuring favorable terms and timely execution
• Conducted provider training and education sessions to ensure understanding of contract terms and compliance requirements

• Managed contracting opportunities and facilitated approval processes, ensuring timely execution of contracts
• Coordinated supply and services contracting within designated domains, optimizing procurement processes
• Conducted negotiations and rate analysis to secure favorable terms and pricing for goods and services
• Implemented and maintained contract management program to track contract pipelines and pricing information

• Oversaw projects and developed tracking systems to streamline data collection and reporting
• Collaborated with cross-functional departments to implement healthcare initiatives and improve operational efficiency
• Conducted quarterly audits and developed tools to track provider claims issues and operational outcomes
• Facilitated the development of standard operating procedures and training materials for various departments

• Managed negotiations, processing, and execution of contracts and agreements for Medi-Cal and Covered California lines of business in San Diego and Imperial counties.
• Led team in analyzing provider network and overseeing multiple network development projects. Researched state rates, contract terms, and language changes. Educated providers on contract terms, payment structures, and.
• Reviewed essential documentation to ensure credentialing applications were submission-ready, including W9s, Certificates of Insurance, CVs, and Malpractice insurance policies.
• Implemented team processes using Microsoft SharePoint, such as Contract Pipeline, Contract Rates, and Letter of Agreements Rates & Contacts. Enhanced contracting forms for improved usability and productivity with Adobe.

• Coordinated provider services, ensuring smooth operations and timely resolution of issues.
• Managed data collection for provider services, maintaining accurate records and supporting contract integrity.
• Assisted in the development and implementation of team processes to streamline operations and improve efficiency.
• Provided support and assistance to providers, addressing inquiries and resolving concerns promptly.

Associate Of Arts - Aa, Business

Bachelor Of Business Administration - Bba

High School Diploma