• Build and maintain positive relationships with healthcare providers through regular communication, active listening, and problem-solving.• Provide accurate and timely information on claims processing, contract terms, network policies, and any relevant updates.• Address provider inquiries and concerns efficiently and effectively, ensuring their satisfaction and resolution.• Negotiate and manage provider contracts, ensuring mutually beneficial agreements.• Gather and analyze data to identify trends and opportunities for improvement within the provider network.• Develop and implement communication materials to keep providers informed of policy changes, new services, and other relevant information.• Collaborate with internal teams (e.g., claims processing, network management) to ensure seamless provider care and service

Welcome to the Music In Us Podcast, where we talk about all things music. We're a group of wildly different people from all walks of life, but we're all united by our love of music. We talk about everything from the latest hits to the classics, and we always have a lot of fun doing it.We believe that music is more than just entertainment. It's a powerful force that can shape our lives in profound ways. Music can make us happy, sad, angry, or inspired. It can help us connect with others and make sense of the world around us. We hope you'll join us on our journey through the world of music.

As a visual artist I employ many methods to shape, form, mould and bring my visions to life. I want YOU to be part of the process. Anyone can take a portrait, including myself of course. So if that's all you need, I've got you covered. However if you want a truly remarkable piece of art of you or your family then I'm the one to come to. I'm my own makeup artist and stylist and have even made gowns for clients on special occasions. I work hard behind the scenes before and after your appointment to ensure that your special piece of art is an heirloom to be handed down from generation to generation.

• Completing focused audits monthly to identify system configuration errors in addition to processor audits to note any trends or knowledge gaps.• Communicating errors to business owners timely, holding them accountable for final resolution• Excelling with a 99.5% annual accuracy average I have identified critical configuration errors, prevented loss of capitol and protected the organization from failing external audit by CMS• Identified potential FWA cases based upon CMS, OIG, DOJ and internal business rules.• Navigating Payer Platform functionality as pertaining to claims performance. From troubleshooting EDI issues to benefit and price mapping. Systems integration issues to Payer Platform coding for modifier pricing reductions, and everything in between.

The Patient Experience Specialist serves as the first point of contact for visitors who enter the facilities and is responsible for all aspects of customer service for Patient Access/Patient Accounts areas in a manner that ensures a customer focused, quality conscious work climate; Primary functions include, focusing on interpersonal skills, data collection, and the ability to assess situations and to assist the team in developing solutions to achieve excellence in customer service while ensuring the financial viability of the hospital; Collecting and verifying patient and insurance demographics, securing pre-certifications and/or pre-notifications for patient services, collection of co-pay and deposits prior to services and providing financial assistance to patient; Responsible for recognizing the patients' ability to pay or need of assistance, as well as, assisting patients in their efforts to obtain services within Community Health Network in a timely manner

With Seven Corners I have the opportunity to serve as a TPA who handles the adjudication of health claims for Federal Inmates across the country.In this role I capitolize on 17 years of experience in the health insurance industry.With my unique blend of knowledge including claim coding, Medicare regulations, Provider contracts, HIPAA and Corporate Training I offer a well rounded package of experience to the table.

• Expert-level review and processing of complex healthcare claims: Accurately interpreted medical records, applying coding guidelines, and identifying potential fraud or errors.• Leading a Team of Claims Examiners with an average 99% accuracy rate.• In-depth knowledge of healthcare insurance policies and regulations: Expertise in relevant coding systems (ICD-10, CPT, HCPCS), Medicare and Medicaid guidelines, and private insurance policies.• Classroom Trainer of new-hire Claims Examiners. Developed custom syllabus, lesson plans, job aids, assessments and class room learning activities. Found value in learning in depth about adult learning styles then applying said principles to a successful training program.• Complex High Dollar Claim Review SME. A subject matter expert in high dollar claims with access to release high dollar health care claims after detailed review. Trained a newly created High Dollar Team with a 100% pass rate.

As a Real Estate Agent I assisted homeowners in buying and selling residential property.

I was in charge of obtaining and relieving staff as appropriate. Maintaining the store schedule, ongoing training and motivation. Store inventory, reporting sales figures to corporate.