VALERIA VICTORIA BELL
To obtain a career oriented position in a professional environment where my skills and abilities, education, and experience will be fully utilized and further developed.
Carefirst, Blue Cross and Blue Shield, Washington, DC 2008-2009
Provider Relations Representative
Â· Uses knowledge of products and contractual provisions that govern administration to provide the highest level of customer and provider service to policyholders, providers, group administrators, brokers, medical professionals, and internal staff.
Â· Assists with policy and procedure interpretation of protocols, policies, and procedures
Â· Resolves administrative problems affecting network providers, patients, and plans within contracted guidelines for which responsible.
Â· Applies an expert ability to analyze client contract determining any factors involving current product, risk assessment, and revenue impact
Â· Develop service technical competence for the purpose of maximizing provider retention, satisfaction, and potential savings.
Â· Responds to telephone, email, and written inquiries and correspondence from subscribers, group administrators, providers, brokers, and medical professional and internal staff.
Â· Responsible for maintaining working relationships with provider network, ensuring the accuracy of the credentialing databases, claim analysis, simple adjustments, benefits, eligibility status, and medical records.
Children’s National Medical Center, Washington, DC 1997-2008
Clinical Operations Representative II
Â· Served as main point of contact for patients, pharmaceutical representatives, and insurance providers
Â· Answered calls using a multi-line telephone system
Â· Coordinated operations for medical personnel and supported multiple physicians simultaneously
Â· Managed the verification and maintenance of insurance authorizations, demographics, and referrals
Â· Obtained preauthorization and managed schedule for all diagnostic procedures and appointments
Â· Scheduled patients appointments daily; prepared charts and other relevant documentation
Â· Received all incoming correspondence and determined appropriate action necessary
Â· Collected, input and updated patient information for the purpose of maintaining the accuracy of multiple computer based database management systems