Carla Douglas, Mba Email & Phone Number

Serve as a Health Insurance Specialist to develop and maintain National EDI Standards. Help develop and issue specifications, requirements, procedures, and guidelines related to Medicare implementation of paper and EDI standards for the 835- Health Care Claim Payment/ Advice Transaction. Serve as the lead for the pre-planning process for reviewing and commenting on X12N version 7030 for Health Insurance Portability and Accountability Act (HIPAA) adopted transactions. Work with other CMS components’ to meet objectives, establish system requirements, contractor performance guidelines, and system interface requirements. And also serve as a Medicare representative, representing the agency at National Standards meeting regarding EDI Standards for Health Insurance Plans.

Baltimore, Maryland Area

Served as a Health Insurance Specialist in support of various tasks and as support lead within the agency to proactively identify vulnerabilities and other issues impacting the program. Served as the support lead to help develop demonstrations, memorandum, reports, and policy changes to better ensure proper Medicare payments and EDI compliancy. And served as a Contracting Officer Representative (COR) to help educate health care providers and practitioners in a variety of settings.

Washington, Dc

Assisted with various administrative and support duties such as:• Assisted with the implementation and accreditation for the Patient Centered Medical Home Health Care Model• Designed a memorandum of practice for the clinic to submit to the National Committee of Quality Assurance• Collaborated with various departments in the clinic on clinical operations processes• Worked with office automation software, such as MS Word, Excel, and PowerPoint, and with office equipment, such as computers, scanners, and copiers• Assisted the operations staff in performing various clerical tasks, such as scheduling appointments, record keeping, filing, data entry, billing, answering and referring phone calls, and customer service

Hawaii

Assisted, conducted, and performed support duties such as:• Prepared management reports on a weekly basis using web-based programs to help ensure mission completion• Researched and provided alternate course of actions for several construction projects for supervisors to help determine which plan will offer the best outcomes• Planned, organized, and coordinated missions with different construction companies that ensured 100% competition of the mission and worked alongside government contractors to help coordinate mission work and maintained a budget of $500,000• Facilitated the successful completion of a several helipads in South Korea• Handled, coordinated, and scheduled the activities of several personnel• Examined and inspected work progress of personnel, equipment, and construction sites to verify safety and to ensure that specifications are met according to Federal Aviation Administration standards• Conducted training of personnel on a monthly basis to help facilitate productivity and overcome difficult aspects of work, along with conducting performance and professional development of team members on a monthly basis

Master Of Business Administration (M.B.A.), Business Administration And Management, General

B.S, Health Administration: Health Systems Management