Rebecca Coffee Email & Phone Number

United States

Sunrise, Florida, United States

Contributed to team achieving $1mil in annual savings via a successful medical expense reduction through targeted agreement reimbursement rate reduction negotiation initiative.• Successfully establish and maintain a robust and competitive provider network within assigned geographic territories, ensuring Member access to high-quality services through effective negotiation, contracting, and retention strategies.• Led medical expense reduction contracting initiative which achieved a %20 yearly out of pocket savings on claims forparticipating maxillofacial surgery providers.• Consistently conducted negotiations and renegotiations that incorporate contractual rates and language provisions, in fullcompliance with established departmental guidelines, to optimize outcomes and ensure effective contract management.• Continuously stay informed and up-to-date on CMS Standards and guidelines, enabling informed decision-making andadherence to regulatory requirements for optimal outcomes.• Coordinate with Provider Data Contract Management and other pertinent departments to ensure all contractual languageis configured correctly for accurate claims adjudication.• Proactively identify gaps in the network and successfully recruit new Facilities and Physicians to fill those gaps, ensuring acomprehensive and robust network that meets the needs of Members and enhances overall service quality and accessibility.

Miami/Fort Lauderdale Area

• Deliver prompt and efficient support as the primary point of contact for Hospital and Ancillary providers, addressinginquiries related to claims, participation, contracting, and servicing.• Generate accurate and comprehensive monthly reports by proficiently creating Excel spreadsheets and leveraging V Lookup, formulas, and functions to streamline data analysis and reporting processes.• Conduct thorough examination, assessment, and documentation of business operations and procedures, resulting inimproved efficiency, enhanced productivity, and informed decision-making for optimized organizational performance.• Effectively collaborate with the Legal team to develop customized agreement templates that align with specificrequirements, streamlining the contracting process and ensuring legally sound agreements that meet the organization'sneeds while reducing time and effort.• Efficiently evaluate and respond to rate proposals and RFPs by reviewing them promptly, issuing appropriate offer letters,and providing timely and effective responses, ensuring a streamlined and responsive process.• Successfully oversee and execute ad hoc projects while ensuring compliance with CMS, ACHA, CLIA, and other relevantregulatory bodies, leading to efficient project completion, regulatory adherence, and overall organizational effectiveness.• Promptly process newly executed agreements into the Avmed database to minimize the need of special claims projects dueto configuration delays.Proactively initiate provider claims reports and effectively supervise special claims projects, ensuring accurate correction and timely completion.• Collaborate with Facilities and Physicians to analyze performance risk scores and identify areas of improvement within risk- based agreements, leading to enhanced performance outcomes and maximized effectiveness of risk management strategies.

Miami/Fort Lauderdale Area

• Drive client satisfaction and successfully resolve Provider issues by coordinating and collaborating with internaldepartments, fostering seamless communication and efficient problem-solving.• Conduct thorough monthly reviews of AR recovery reports with facility owners, identifying and presenting increasedrevenue opportunities that result in a significant 20% overall increase in paid claim amounts.• Deliver impactful in-service training and education sessions to clients in collaboration with Clinicians, resulting in increasedknowledge, improved skills, and enhanced client satisfaction.• Effectively communicate quarterly performance figures to potential key stakeholder Clients and leadership, providingvaluable insights and demonstrating the organization's achievements and growth.• Thoroughly research and review claims issues to identify root causes, implement effective solutions, and streamline claimsprocessing, resulting in reduced errors, improved efficiency, and enhanced customer satisfaction.• Successfully submit rate proposals for new agreements to multiple Health Insurance companies on behalf of clients in theportfolio, facilitating competitive pricing, expanded coverage options, and favorable terms.• Efficiently support clients in completing and submitting credentialing documents, ensuring a streamlined process thatexpedites credentialing approvals and enables timely access to services.

Plantation Fl

Effectively managed a high volume of account management calls, efficiently processed payments, promptly addressed general product and service inquiries, and initiated dispute claims, resulting in improved customer satisfaction, streamlined operations, and resolution of customer issues in a timely manner.• Awarded "Platinum Standard Award" in recognition of consistently achieving outstanding call metrics and maintaining exceptional customer approval ratings during performance evaluations.• Effectively served as a proactive liaison between the Company and clients, facilitating seamless communication, building strong relationships, and ensuring client needs and expectations are met with utmost satisfaction.• Successfully planned and coordinated impactful meetings, seminars, and conferences, fostering productive collaboration, knowledge sharing, and networking opportunities.• Performed comprehensive research on a wide range of client requests, diligently analyzing data and information to provide valuable insights and informed recommendations.• Proactively engaged with clients to secure and coordinate travel, dining, and entertainment reservations on their behalf, ensuring seamless experiences and exceeding their expectations.• Delivered efficient and timely customer service, resolving a variety of credit card-related issues promptly and effectively.

Miami/Fort Lauderdale Area

• Efficiently processed customer payments and proactively initiated client transaction disputes, ensuring accurate financial transactions and timely resolution of any issues.• Meticulously documented detailed and accurate information regarding issues, concerns, and necessary follow-up actions within the American Express SharePoint tracking system.• Demonstrated effective listening skills to identify and promptly address client needs, resulting in proactive resolution and prevention of call escalations.• Consistently maintained an empathetic and professional demeanor when communicating with all clients, fostering strong relationships, promoting customer satisfaction, and ensuring positive interactions.• Efficiently coordinates the distribution of educational materials, ensuring widespread dissemination and access to valuable information.• Delivered prompt and effective assistance to customers with standard website navigation inquiries and non-complex troubleshooting, resulting in streamlined user experiences, improved customer satisfaction, and efficient problem resolution.• Proactively addressed and swiftly resolved urgent client issues through multiple communication channels, including telephone, email, and chat support.

Hallandale Beach Fl

• Performed duties with confidence, with minimal supervision, willingness to exceed expectations and sound judgment to mitigate risk of the company.• Simulated and recreated client issues to resolve technical difficulties• Addressed and resolved urgent client issues via telephone and email• Handled a high volume of basic account management calls, processed payments, answered general product and service inquiries• Served as company brand ambassador at conventions and annual conferences and educated audiences on future releases• Educated Zumba staff and instructors by assessing needs, designing and developing training and educational materials and training appropriate audiences/customers• Corresponded with customers via email and telephone regarding various needs to minimize consumer response times• Listened, empathized with and resolved escalated calls and concerns to encourage customer loyalty and foster positive experiences

Bachelor Of Business Administration - Bba, Business Administration, Management And Operations

Activities and Societies: Delta Mu Delta Business Honor Society

Associate’S Degree, Merchandising, 3.4

Activities and Societies: Active member of Alpha Phi Omega. In depth education on the A-to-Z processes in the merchandising business.

Master'S Degree, Health/Health Care Administration/Management