Provider Relations Specialist
Current-Supported providers across multiple states by addressing issues related to claim procedures, authorization requests, and adherence to CMS guidelines.-Coordinated escalation emails to various departments, ensuring prompt follow-up and clear communication across multiple entities.-Applied extensive CPC knowledge to facilitate proper CPT coding application, aligning procedure and diagnosis codes for efficient claim processing.-Conducted call auditing for member services, contributing to quality assurance and MCAG filing processes through cross-training.-Simplified grievance and appeal process by creating training videos and visual guidelines for member services, enhancing efficiency.-Contributed to community outreach and volunteering efforts in Florida as a member of the Florida Ambassadors and Phone Pals.