Chris Hoadley Email & Phone Number

Florida, United States

United States

Established and monitored Key Performance Indicators (KPIs). Responsible for timely completion of provider data changes as well as the maintenance, integrity and validity of Provider Data Policies, procedures and work processes.Managed and reported on Provider Data Integrity, Accuracy, and trends while providing recommendationsOversaw the resolution of claims payment and provider set-up issuesPlanned, coordinated and participated in scheduled and unscheduled meetings with providers to conduct orientations, train providers on health plan policies and procedures, delivered materials while inquiring about contracting with our health plan.Reported team Performance metrics identifying and implementing improvements to increase while maintaining productivity and effectiveness.Collaborated with various cross-functional departments on complex and escalated issues to identify, report and implement solutions, while supervising a staff of 13 employees.

Reviewed inbound requests for accuracy and routed to provider changes and other cross functional teamsAudited complete requests for accuracy and compliance with standardsMaintained a database for provider changes and validated new database entriesResolved complex provider data issuesAnalyzed and advised management of personnel and workflow issues and resolutionsReviewed, investigated, and generated reports for internal and external customersSubmitted daily and weekly internal and external status reportsCompleted audit analysis reports, inventory reports and submitter’s status reportsMaintained standard operating procedures and assisted management with departmental policies and proceduresWorked with provider data and credentialing team to audit data exchangesAssisted Provider Data Coordinators with questions and training need Qualifications

United States

Performed health plan provider orientations and conducted ongoing educational outreach with a focus on improving quality and financial outcomes within the provider network. Acted as a liaison between providers and the health plan to enhance the business relationship. Conducted initial provider orientations as well as ongoing educational outreach. Educated providers regarding policies and procedures related to referrals, claims submission, credentialing documentation, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface. Enhanced account relationships by investigating, documenting and resolving provider matters and effectively handling and responding to account changes and correspondence. Engaged providers and educated them on Patient Centered Medical Home initiatives. Performed detailed HBR (Health Benefits Ratio) analyses, Health Information data Information Set (HEDIS) analyses, and create reports for provider Review provider performance by both quantitative metrics and qualitative factors. Created and communicated milestone documents, dashboards and success or improvement metrics. Acted as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance Provided information and status updates for providers regarding incentive agreements.

United States

Served as acting supervisor of department when management team unavailable. Personally managed all breast center specialists in areas of outpatient scheduling and registration. Responsible for documenting all errors relating to inpatient verification; including training/counseling employees on accurate scheduling procedures / guidelines. Monitored incoming call flow and productivity over all employees through Cisco Supervisor Phone Agent for over 15 skill sets. Collaborated in meetings throughout the year with department supervisor and other team leads to improve daily operations, employee morale, increase call volumes, and other various departmental issues. Personally chosen by management, solely responsible for all registration, and benefit verification regarding inpatient services. Responsible for communicating with over 20 different insurance companies, and obtaining personal benefit information and accurately placing into patients accounts