Amanda Evans Email & Phone Number

Cameron, Nc, Us

Remote

• Ensured provider data accuracy for Accountable Care Organization groups per a roster/register by data extraction and analysis using various systems and databases such as Examiner, ARC, Impact, NDB, etc.• Developed, maintained, coordinated updates for database integrity while meeting quality assurance standards and retaining our customers• Collaborated with other departments regarding database and systems improvements• Assisted in audits and data quality improvement initiatives• Partnered with UnitedHealth Networks, Health Plans, care providers and medical groups to maintain current roster, demographics, and network status to ensure the accuracy of network profiles• Performed comprehensive data and contract reconciliations along with ensuring new contract provisions were successfully executed across all platforms and processes• Managed change requests and data corrections through to claim payment and directory depiction• Implemented remediation plans for providers with submissions and closed inaccuracy gaps

• Proficient with UnitedHealth Group systems - NDB, CSP Facets, COSMOS, PhyCon, Titan, Orbit, and SharePoint platforms• Subject matter expert (SME) on a cross-functional team responsible for identifying root causes to assist with quality defect reduction with Provider Data Operations and implemented training along with updating processes to improve the overall quality• Part of the Value Check Project with the Contract Analytics Team; this project used root cause analysis to identify which area of contract loading were having quality issues, trained the Data Loading Analysts on their specific quality issue, and ensured corrections were performed accurately on provider’s profile• Collaborated with other departments to assist with their projects: Community & State/Medicaid Orphan Member Burndown and Load Before Effective Date (LBED)• Developed improvement plans for Data Loading Analysts (DLAs) in the Buddy Program through auditing and training to improve their overall performance• Lead On-Job-Training (OJT) development virtually and on-site in Phoenix, AZ and Richardson, TX for Regional Contract Loading (RCL) teams• Identified top trending quality defects within Provider Data Operations and facilitated quality remediation meetings that lead to quality score improving to 97%• Collaborated with Provider Data Operations to drive process improvement initiatives by creating and updating current Standard Operating Procedures (SOPs) and other processing documents

• Installed provider contracts accurately utilizing various databases and systems • Audited contract loads for adherence to quality measures and reporting standards• Investigated urgent contract issues and processed corrections within a 24-hour turnaround time• Audited new hires work to correct possible errors, improving overall quality

• Accurately and efficiently processed all lines of business in Clinical Services• Managed inventory of Blended Census Report and assigned work to the team• Tracked and confirmed admissions and discharges• Applied knowledge of ICD-9, DRG/NON-DRG, and CPT codes to ensure proper payment to providers• Trained new hires promptly after starting the position• Received several awards for performance between June 2015 and November 2015

Greensboro/Winston-Salem, North Carolina Area

Cosmetology/Cosmetologist, General

Computer And Information Sciences And Support Services