Provider Relations Liaison Resume Example
CPC Certification through the American Academy of Professional Coders. Knowledgeable in ICD-9, ICD-10, CPT, HCPCS and E&M coding guidelines. | Experience working remote Knowledge of health care, managed care and Medicaid |
Mercy Healthcare – Marietta , OK
Works as a Provider Relations Liaison for Ped-I-Care, a managed health plan that administers health insurance benefits for children with special health care needs whose families have a low income. Ped-I-Care is currently contracted to administer benefits for the Children's Medical Services Medicaid Managed Care plan.
- Recruits, retains, and educates a large network of health plan providers in my assigned provider community spanning 8 counties in the Big Bend region of FL.
- Conducts periodic on-site visits and training, distributes network materials, communicates plan provisions and guidelines, and facilitates resolution of any disputes including billing and claims issues.
- Acts as a liaison between internal departments of Ped-I-Care and the provider community.
Tallahassee Memorial HealthCare – City , STATE
Handled the daily operations of the Nursing Operations/Central Staffing Office with the primarily responsibility of recruiting and scheduling all existing Float Pool staff (RN/LPN/CNA/Sitters) to fill the staffing needs/vacancies in 10+ hospital units.
- Reviewed patient census and acuity databases prior to the beginning of staff shifts for analysis, interpretation and comparison of the workload, staffing needs and available Float Pool staff. Used this information to utilize staffing resources in an efficient and cost-effective manner.
- Served as liaison and mediator for Float Pool staff and unit managers through all phases of staff placement.
- Reviewed and verified time /daily punch detail reports for Float Pool employees and made corrections as needed.
Bay Medical Center – City , STATE
Provided optimum patient care as a Certified Nursing Assistant.
- Preserved and assured patient's dignity while carrying out tasks such as taking blood pressures, temperatures, diapering, bed-pan changes, bathing and emptying drainage bags.
- Constantly complied with HIPAA confidentiality standards while preparing patient documentation and in other interactions.
University of West Florida - City, State
University of West Florida - City, State
Gulf Coast Community College - City, State
- Certified Professional Coder (CPC)
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Resume Overview
School Attended
- University of West Florida
- Gulf Coast Community College
Job Titles Held:
- Provider Relations Liaison
- Staffing Systems Coordinator
- Patient Support Associate
Degrees
- Master of Science : Healthcare Administration , 2013
Bachelor of Arts : Special Education , 2011
Associate of Arts : 2007
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