Nicolé Jones Email and Phone Number

• Promoted multiple times throughout the life of the MPC (Maryland Physicians Care)contact• Addressed issues and resolve provider data management deficiencies to ensure proper management of healthcare claims• Enrolled providers: verified credentials, pay class and contract documentation • Supervised staff to include; monitor team performance, managing professional development and coaching and delegating tasks and duties to meet organizational objectives• Developed policies and procedures to improve efficiencies operational practices• Managed recordkeeping systems, forms control, office layout, and budgetary and implementing organizational changes• Developed leadership skills and expanded professional networks with educational workshops; reviewing professional publications; participating in professional societies and mentoring others

• Subject matter expert and inter-departmental liaison, managing internal and external inquiries• Developed policy, procedures and workflow to improve operations• Assisted the VP, Operations and other key operational staff• Managed facilities issues, as needed

• Serve as liaison between various departments internal and external.• Assist in developing policy and procedures by developing processes and desktop, oversee various projects. Lead and facilitate various workgroups and committees • Support management team with supervisory coverage of the service floor, front desk and other areas as applicable when leadership is unavailable due to onsite/offsite meetings training etc. • Secondary Lead for all building/facility issues

• Managed escalated calls from providers and resolved issues to their satisfaction• Lead contact for delated issues with provider portal• Managed issues with various member complaints and addressed inquiries in a timely fashion• Assisted leadership to ensure projects, reporting and other deadlines were met

• Provide health information to individuals once approached and explain health benefits that are offered by health plan. • Set up table display to attract the community while providing marketing materials (give a ways) to promote MPC within the communities.

• Managed month-end reporting and daily account payables and receivables and other computerized cash-handling for operational efficiencies• Maintained electronic funds transfers for providers and manage checks and other financial transactions, including remittances• Completed associated administrative tasks and clerical duties• Key contact for specialized billing/budgeting analysis for IRS and other requests

• Triaged telephone inquiries form providers and members• Assisted leadership with a variety of projects to improve operations• Managed refund checks, remittances, and credentialing documentation and other correspondence

• Processed electronic and telephonic medical prior authorizations requests• Prepared documentation for data entry and assigned numerical codes for entry, verification and accuracy