To obtain a position with that will enable me to utilize my strong personal drive,
exceptional leadership abilities, and well developed communication skills while providing
a maximum contribution to the goals of the organization
Excellent interpersonal communication and relationship-building skills. Listen
Attentively, communicate persuasively and follow through diligently
Ability to succeed in high stress and demanding situations
Effective problem solving and decision making; exceptional interpersonal skills; multi-
Tasker; self motivated; positive attitude; oral and written communication skills
Technically skilled-proficiency in Word, Excel, PowerPoint, and Access
Retail and management
Written communication skills
Network Services Representative/Provider Relations, 01/2010 to Current Windsor Health Group, Inc – Little Rock, AR
Effectively negotiate contract language and rate structures; Assist in reviewing and
preparing contracts with facilities, laboratories, and group physician practices.
Assist in the design and implementation programs to build and nurture positive
relationships between the health plan, providers (physician, hospital, ancillary, etc.),
and practice managers.
Resolve complex provider claims, contracting, and capitation issues; work with internal
departments and management to resolve issues and recommend solutions.
Plans, organizes, and conducts education training seminars for the assigned provider
Educate participating providers regarding policies and procedures; review existing
policies to ensure maximum compliance, troubleshoot issues raised by providers, distribute
any needed material, identify non-compliant providers, and providers with member
Update out of network negotiations in Access database; assist with processing pricing
and termination requests.
Adequately documents and maintains records relative to communication with assigned
providers to ensure a mutual understanding of expectations.
Acquires and demonstrates a thorough knowledge of territory provider operations
including interrelationship among other area providers, and shares gathered reimbursement
and other information on competing entities.
Patient Accounts Representative, 07/2008 to 01/2010 Practice Plus/Arkansas Health Group – Little Rock, AR
Provided assistance to clinic staff in determining cause of payer delays in
reimbursement and performed necessary functions to receive payment in a timely manner.
Performed insurance billing, both electronic and paper on a daily basis.
and posted insurance denials in a timely manner, and took appropriate action to ensure
payment of claim, according to guidelines.
Researched credit balances and processes of refunds or transfers to the appropriate
party on a weekly basis or according to clinic/department specific guidelines.
Actively reviewed patient and insurance information by utilizing available resources
such as clinic staff, patient contact, and systems to facilitate accurate billing.
Posted all receipts from both patients and payers to the appropriate line item in a
Differentiated between contractual and non-contractual adjustments,
applying appropriate write-offs to patient's account.
Performed daily close after verifying all charges, receipts, adjustments and refunds
balance to computer generated reports.
SIMS Coordinator/Assistant Manager, 05/2007 to 06/2008 Walgreen's – Monticello, AR
Assisted in planning and implementing sales, promotional, and advertising programs.
Assisted in recommending and implementing Company policies and procedures designed to identify and minimize profit loss.
Assisted in implementing and attaining payroll expense objectives.
Audited own performance and recommended objectives and standards of performance.
Received, stocked, and priced merchandise while maintaining stock files and reports.
Maintained an awareness of developments in the retail and management field that related to job responsibilities and integrated them into own practices.
Evaluated existing operations and current market trends to identify necessary improvements and capitalize on changes.
Communicated best practices among on-site and external personnel to align efforts and goals.
Evaluated employee performance on [Timeframe] basis and conveyed constructive feedback to improve skills.
Master of Education: Learning Systems TechnologyUniversity of Arkansas at Little Rock Little - Rock, AR
Bachelor of Business Administration: FinanceUniversity of Arkansas at Monticello - Monticello, AR