ERRIN POSTON
OAKLAND
Summary
Proven Provider Services Representative at Alameda Alliance for Health, adept in HIPAA compliance and claims processing, significantly enhanced customer satisfaction. Leveraging a goal-oriented mindset and call center experience, I streamlined operations and improved provider relations, demonstrating exceptional problem-solving and communication skills. Achieved notable efficiency in handling high-volume inquiries and complex claim disputes.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Provider Services Representative
Alameda Alliance for Health
03.2018 - Current
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Streamlined operations by managing a high volume of incoming calls for medical providers seeking information or assistance.
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
- Increased efficiency by accurately entering provider data into company systems and databases.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
- Evaluated provider contracts for accuracy and completeness before submission to final approval process.
- Served as a reliable resource for both internal staff and external partners, offering guidance on best practices in managing provider relationships.
- Analyzed performance metrics for assigned territory, identifying opportunities for growth and improvement within the network.
- Provided exceptional support for credentialing processes including application completion, background checks, primary source verification activities as well as ongoing maintenance tasks such as recredentialing requests.
- Implemented targeted outreach programs to educate providers about policy changes and updates.
Claims Processor
Alameda Alliance for Health
11.2014 - 01.2018
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Addressed complex customer issues involving claim denials or delays, demonstrating strong empathy and professional demeanor.
- Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
- Enhanced claims processing efficiency by meticulously reviewing and validating documentation for accuracy.
- Developed strong relationships with healthcare providers and insurance agents to facilitate seamless communication during the claims process.
Office Assistant
Sutter East Bay Medical
11.2008 - 07.2013
- Maintained strict confidentiality of sensitive information during execution of administrative duties.
- Enhanced office efficiency by managing schedules, organizing files, and maintaining a clean workspace.
- Facilitated smooth operations by efficiently handling incoming mail, phone calls, and visitor inquiries.
- Expedited document processing with accurate data entry and timely filing.
- Increased customer satisfaction by providing professional and courteous front desk support.
- Supported financial operations including invoicing, expense tracking, and budget preparation to maintain accuracy.
- Ensured executive team received meticulously prepared presentations, reports, and meeting resources.
- Supported onboarding process for new hires, enhancing their integration into team with comprehensive orientation sessions.
- Improved office supply inventory management, reducing unnecessary expenditures by regularly auditing and ordering supplies.
Education
Mass Communication - Organizational Communication
California State University, East Bay
Hayward, CAAssociate Of Liberal Arts - Liberal Arts
College of Alameda
Alameda, CA05.2008
Skills
- HIPAA compliance
- Claims processing
- Goal-oriented mindset
- Call center experience
- Insurance verification
- Healthcare industry
Certification
CPR Certification
Timeline
Provider Services Representative
Alameda Alliance for Health
03.2018 - Current
Claims Processor
Alameda Alliance for Health
11.2014 - 01.2018
Office Assistant
Sutter East Bay Medical
11.2008 - 07.2013
Mass Communication - Organizational Communication
California State University, East Bay
Associate Of Liberal Arts - Liberal Arts
College of Alameda
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