Raquel Howard Email & Phone Number

Glen Ullin, Nd, Us

North Dakota, United States

Perform data entry while displaying a high level of detail and accuracy capturing usage and cost information from utility invoices while maintaining data entry exception reports. Ensure quality control by locating and correcting data entry errors.Works in a high-energy office environment, performing various functions related to utility bill processing. This multi-faceted role will require the individual to specialize in one focused area, as well as cross-train in all other areas to assist team members when needed. Must be flexible and adapt to the needs of both the customer and the team.

North Dakota, United States

Implements an all-product quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes. Links the quality management activities to business goals by using innovation, integration, and information. Participates in the development and ongoing implementation of Quality Management (QM) work plans and activities.Implements an all-product quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes. Links the quality management activities to business goals by using innovation, integration, and information. Participates in the development and ongoing implementation of Quality Management (QM) work plans and activities.Works to achieve day-to-day objectives for the Health Care Quality Management (QM) function.Assists in the development and implementation of QM projects and activities.Converts results of data analysis into meaningful business information to disseminate conclusions about the overall function of the department.Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements.Recommends corrective actions regarding credentialing events and potential quality concerns through clinical analysis.Performs quantitative and qualitative data analysis to achieve operational targets.Prepares QM documents that adhere to the interpretation and application of business requirements.Reports business information to internal and external constituents and consults on solutions for emergent issues.

Bismarck, North Dakota

Develops/maintains standards for credentialing data ensuring database integrityCompliance with legislative, regulatory & accrediting body requirementsManages communication with other departments regarding credentialing processes/database improvementsProvides education/training to providers and internal customers on credentialing policy/proceduresWorks collaboratively with network staff (local/regional) in issue/problem identification & resolutionConducts ongoing process audit to evaluate compliance with standards & outcomesAudits timeliness, maintains resource material & library of available resourcesProvides coaching/mentoring to peersAssists with training to staffCreates/manages action plans for assigned projects relative to special network initiatives, workflow or quality improvementsCoordinates receipt of provider data with outside vendors & other entitiesAssists & maintains collections of data, tracking & reportingAssesses business benefit & cost of existing technology-based service or productMonitors exception processes and outcomes & recommends process improvements based on trend analysisInterprets/handles highly sensitive investigative activity in preparation for CPC/ongoing sanction activity of at risk providersReviews, analyzes, evaluates, validates provider information against credentialing requirements & maintains information in data basesSupports extensive research & analysis of sensitive provider issues; addresses data integrity issuesMaintains high production & quality factorsIdentifies improvement opportunities & recommends enhancements & workable solutionsDirectly contacts providers/outside entities to clarify data quality issuesProvides issue resolution for providers during the credentialing or data management processesPerform data entry & systems maintenanceProcesses monthly updates to the Linked Before Credentialed reportAdheres to the strict confidentiality standards of HIPAA, state & federal health insurance standards

Glen Ullin, Nd

Serve residents balanced mealsPreparation and clean up of mealsCharting intake of fluids and foods for residentsOther duties as assigned

Mandan, North Dakota

Performs data entry while displaying a high level of detail and accuracy capturing usage and cost information from utility invoices while maintaining data entry exception reports. Ensure quality control by locating and correcting data entry errors. Performs various functions related to utility bill processing. Multi-faceted role specializing in one focused area, as well as cross-train in all other areas to assist team members when needed.

Bismarck, North Dakota

Responsible for support of activities in the Credentials Verification Center.Performs detailed verification and data entry functions.Performs primary source verification of practitioners, facilities and providers credentialing information.Processes initial credentialing applications. Review and verification of information submitted by providers by performing mail, database, and Internet queries.Facilitates process of recredentialing current physicians in the provider network. Activities include, but are not limited to, the review and verification of information submitted by providers by performing mail, database, and Internet queries.Maintains accurate provider data in the CPD and other applications through accurate data entry and verification as necessary.Updates and maintains all active ancillary providers’ files, including verification of current licensure and accreditation status.Updates and maintains all active credentialing files to ensure that all information is current.Assists with preparation for Credentialing Committee meetings.Assists leadership in auditing files.Follows credentialing processes and procedures to improve efficiency and quality of files.Performs other duties as required.Adheres to the strict confidentiality standards of HIPAA.Adheres to state and federal health insurance standards.05/13 received promotion from Credentialing Associate to Credentialing Coordinator.Coventry purchased by Aetna 05/13 and position transitioned to Aetna 01/14.

Bismarck, North Dakota

Provide high quality, customer focused service, using knowledge of plans, products, systems and procedures, to meet and exceed physician, hospital, and all other provider expectations, which results in enhanced member satisfaction.Answer questions and resolve issues based on phone calls from physicians, hospitals, and all other providers. Identify service problems and initiate appropriate action to resolve problems.Access information from a variety of systems and references. Utilize systems to track all events and outcomes. Educate physicians, hospitals, and all other providers on a daily basis through routine calls regarding the status of claims.Completed numerous on-line management and self-improvement courses on a weekly basis.Adhered to the strict confidentiality standards of HIPAA.Adhered to state and federal health insurance standards.

Minot, North Dakota

Processed financially accurate transactions through mainframe and PC technology.Reviewed and rewrote documentation on significant insurance contract processes, which improved team performance. Administered policy contract changes in compliance with product and legal requirements. Processed various transactions relating to the policy billing and premium functions including changes to payment mode, amount and method, processing returned items from the bank, processing special payment arrangements, and performing billing audits.Accurately processed updates on clients’ information such as address, phone, and bank information.Participated in special projects to increase processing efficiency.Adhered to state and federal regulations concerning life insurance.