summary accomplishments skills experience jessica claire montgomery street san francisco ca 94105555 4321000 resumesampleexamplecom qhighly motivated sales associate extensive customer service sales experience outgoing sales professional track record driving increased sales improving buying experience elevating company profile target market certifications lean six sigma green belt certified ms office word excel power point access outlook peachtree sql basics mount sinai health system provider services specialist 122017 present act primary point contact participating providers within provider partners mount sinai ipa identifies addresses provider file data setup issues impact claims problems ensures claims issues addressed timely accurately conducts root cause analysis large claims projects submitted performs routine evaluation provider network performance including network adequacy membership growth opportunities thorough understanding providers contract payer arrangement including care coordination fee structure physicians network educate ensure providers participating meetings clinical integration webex training sessions requirements cin program collaborate salesmarketing provider recruitment departments support campaign launches ongoing recruitment efforts participate various qi committees work groups improve health care quality member satisfaction outcomes assist credentialing team health care plan enrollment process ipa voluntary providers including gathering reviewing enrollment requests applications contracts completeness accuracy review regulatory changes communicate updates ipasprovider community needed paotner relations specialist petco delivery system reform incentive payment program dsrip 032017 present serves liaison project management office pmo partner organizations mount sinai performing provider system pps areas provider education front line problem solving monitor assure regulatory documentation maintains corporate standards including contracts business associate agreements disclosures protected health information phi stay abreast updates new regulations nys doh ensure partners track progress work partner organizations assess current business models operational workflows practice management systems identify opportunities improvement efficiencies develop maintain positive relationships partners drive dsrip goals troubleshoots issues provides timely follow help design quality improvement initiatives implement improvement interventions evaluate effectiveness interventions mcximus quality assurance coordinator 012017 032017 ensure employees compliant healthcare compliance business ethics policies guidelines analyze collected audit data identify trends staff retraining implementing corrective action plans collaboration call center management staff ensure documentation produced processed complies state regulations requirements perform periodic compliance audits risk assessments conduct related ongoing compliance monitoring activities assist developing producing conducting compliance training programs enter transcribe record store maintain information written electronic magnetic form relating services processes quality systems monitor effectiveness quality incomingoutgoing calls made enrollment counselors well effective training received product services system applications etc moximus new york medicaid choice 082017 122017 educate enroll consumers medicaid managed care plans managed long term care plans fida harp program analyze evaluate results provide consumers best solution ensure eligibility enrollment services compliant federal state hipaa regulations work companys primary mentortrainer new employees operate multiline phone system heavy telephone support assisting areas administrative work including executive support office management data entry document preparation education training bachelors science business administration york college city university new york business administration may 2012 certifications student activities york college student government vice president york college bengali club president meeting event organizer languages english hindi oral bengali reading writing activities honors skills administrative call center oral compliance audits contracts data entry delivery doh documentation english government hindi marketing meetings mentor access excel ms office office outlook power point word network office management organizer peachtree phone system policies problem solving processes producing progress project management protected health information quality quality improvement reading recruitment sales sql telephone trainer training programs written