DPP1

The care of cemetery grounds and assistance with burial arrangements.

Complete general contractor company. Responsible for lot clearing, excavation of lot and site preparation. includes setting elevations and forming footer or footers. skilled machine operator, skid steer, excavators, grading, setting steel beams for first floor support. I have taken on both commercial and residential renovations and new construction. pick up and deliver building materials to each site. I really enjoy and excel at running equipment. I can say there is always a few items my boss or co worker's can suggest to sharpen skills. Overall, I enjoy interacting with the customer and making sure all reasonable expectations are met.

Responsibilities:1. Manage current and recently executed provider contracts, for each IDOC correctional centers. Examples provider specialties include; oral surgeons, general surgeons, psychiatrists,ophthalmologists, cardiologists and oncologists/hematologists and orthopedic surgeons.2. Maintain/update preferred provider lists, for all IDOC state correctional centers.3. Resolve provider's claims and reimbursement issues.4. Identify provider specialists, in need at any particular correctional center. Contact local providers to negotiate (PRN) case by case contracts, and attempt to negotiate a formal long term agreement to provide medical services at all near by correctional centers.5. Update, remove and add provider's to each correctional center's preferred provider directory, every quarter. Communicate to each IDOC correctional center, by sending management approved assessment/feedback forms to obtain suggestions and improve the overall healthcare process.6. Communicate providers who provided superior care, but currently not contracted or under agreement to provide medical neccessary and authorized medical services, with specific reimbursement details and responsibilities outlined in a contract and/ or agreement under an agreement. The negotiation process began by communicating with the provider's office manager or appropriate staff, and the negotiation process to execute a long term agreement.7. Review high dollar claims, and non- conrtacted providers to negotiate a payment payment proposals, (i.e. air ambulancetransportation services). 8. Maintain/update all IDOC site manager's, sceduling and medical records personell, at each IDOC Correctional Center.

Complete assigned tasks, per upper management. Maintain project timeline and supplies on site, or materials and labor needed to complete project deadlines. Ensure other teams have required tools to complete assignments and stay on schedule. This contractor recently changed their name to BD Development, Inc. I have had several long periods of employment with the same owner/contractor, since 1997. I would like add other skills which includes Granite countertop fabrication and installation process.

I perform the quality control and analysis of all new provider and existing provider record updates, as requested by our Provider Contracts and Provider Relations departments. This includes demographical updates, rate updates, network and contractual updates, and provider contact information, which is stored in the company’s provider repository/database. I also assist in the processing of implementing annual rate updates and fee schedule mailings to our contracted facility and ancillary providers. This includes; hospitals and their distinct part units (Psych, Rehab, Substance Abuse/Detox, etc.), skilled nursing facilities, home health and hospice agencies, ambulatory surgical centers, dialysis providers, ambulance providers, durable medical equipment providers, orthotic and prosthetic providers, and service providers.

The completion of provider change/update requests and new provider requests as submitted by Provider Contracts and Provider Relations. Provider types range from Hospitals, Distinct Part Units (Psych, Rehab, Detox/Substance Abuse), Ambulatory Surgical Centers, Inpatient Psychiatric Hospitals, Long Term Care Hospitals, Skilled Nursing Facilities (Hospital Based and Freestanding), Hospice Providers (Hospital Based and Freestanding), Durable Medical Equipment Providers, Orthotic and Prosthetic Providers, Ambulance, and Home Health Providers (Hospital Based and Freestanding). This process includes verifying and reviewing all provider information, which is dissected from the provider’s agreement or contract (Facility or Ancillary Provider Agreement). The information is then updated or added to the Corporate Provider Repository (Provider Database). Some of the key informational components include; provider demographics, rate information, contact information, and provider network(s) affiliations, specialties, identification numbers (NPI, Tax ID, Medicare, and assigned health plan ID numbers), and current executed agreement, amendment, and addendum information. Processing any changes related to provider mergers, buy-outs, and changes in ownership. These types of provider updates require analyzing all legal documents (Consent to Assignment Agreements and Sales Agreements) and making the appropriate changes to provider records, terminating provider records, or creating new provider records. The completion of provider payment rate exhibits. This process includes reviewing the facility's rate proposals and transferring rate information on to the Payment Rate Exhibit, according to the template filed with the Pennsylvania Insurance Department (PID). This process requires strong attention to detail and quality due to the PID's requirements and standards.

I responded to and handled telephone and/or written inquiries from member's and provider's about benefits, claims, prescription drug benefits, billing issues, provider participation, member submitted claims, web-site navigation and complaints accurately and in a timely manner. I maintained 99.45% quality during my last twelve months, as a customer service representative.I provided assistance and training to new representatives and management on specific group benefits and procedures.I provided member and provider assistance with all types of health care products, PPO, POS, Indemnity, Comprehensive, Medicare Advantage, and I handled inquiries from local and national members and providers.

The preparation and cooking of all pizza items.Serving customers, in the dining room, and performing all monetary transactions.Maintained high quality menu items and customer service.

Granite countertop fabrication, from slab to finished and installed countertops. Managed all aspects of fabrication and installations, and I also trained new employees and helped develop skill set required for fabrication process. Always followed specific direction and instructions from upper management or owner.