Ryan Bruce

· Managed provider credentialing and provider payment enrollment processes for 40 practices and 60 doctors

· Oversee enrollment process for providers with any and all payers

· Work closely with RCM manager to escalate any issues

· Manage CAQH

· Work with payers to determine in network status’s and establish negotiated rates for new payers.

· Validate re credentialing requests ie: directory validations, payer inquiries

· Assist all practices with payer escalation and get to the root cause of any complications that may arise.

• Entered incoming orders into Esker software and SAP
• Verified orders for accuracy
• Processed approximately 22 orders daily
• Upheld strict data privacy standards while handling sensitive customer information during order entry process
• Facilitated cohesive work environment through active participation in team meetings, sharing updates on current projects, challenges faced, and best practices learned from past experiences
• Expedited delivery times by prioritizing urgent orders and coordinating with logistics personnel
• Collaborated with team members to ensure timely and efficient fulfillment of customer orders
• Enhanced order accuracy by meticulously reviewing and verifying customer information and product specifications

• Processed claims through entire revenue cycle
• Processed approximately 30 to 40 claims daily
• IE: Coordination of Benefits, Claims processing, Claims Management, Claim Investigation, Claim Handling and Resolution for Orthodontic claims across multiple, Multi-State practices
• Coded claims forms and mediated disputes between carriers and clients
• Recommended and communicated goals to help team excel against targets
• Delivered exceptional customer service to clients by communicating information and actively listening to concerns
• Input claim information and payments into company database
• Checked into questionable claims, interviewing agents and claimants to resolve errors and omissions
• Monitored pending claims closely to identify potential issues or delays in processing promptly addressing them before escalation occurred
• Maintained strict adherence to confidentiality guidelines, ensuring sensitive client information was securely handled and protected at all times
• Increased accuracy in claims data entry, ensuring proper documentation for future reference and audits

• Performed basic maintenance and cleaning
• Cleaned various work areas by mopping, vacuuming and polishing mirrors
• Walked property and grounds, picking up trash and debris to maintain curb appeal
• Demonstrated dedication and work ethic through consistent attendance and top-level performance
• Drove vehicles to different areas of dealership to meet display standards
• Moved and worked with vehicles to support sales activities
• Maintained a clean and welcoming environment for guests through regular cleaning of lobby, hallways, and restrooms
• Improved overall cleanliness standards within the property by performing routine maintenance tasks such as changing light bulbs, fixing minor repairs, or reporting larger issues to management

• Managed office inventory and placed new supply orders
• Doctor Credentialing
• Dental Fee plan negotiation
• Monitored payments due from clients and promptly contacted clients with past due payments
• Maintained impeccable office organization to support efficiency, professionalism and performance objectives
• Oversaw receiving and organizing correspondence, answering and forwarding calls and creating business letters and records
• Managed, scheduled and coordinated office functions and activities for employees
• Handled scheduling and managed timely and effective allocation of resources and calendars
• Used judgment and initiative in handling confidential matters and requests
• Implemented and maintained company protocols to facilitate smooth daily activities
• Elevated customer satisfaction ratings by promptly resolving client and case issues
• Trained and mentored administrative staff members in company policies, daily task execution and industry best practices
• Remained calm and professional in stressful circumstances and effectively diffused tense situations
• Resolved customer inquiries and complaints requiring management-level escalation
• Delegated work to staff, setting priorities and goals
• Reviewed completed work to verify consistency, quality and conformance

• Managed budget implementations, employee reviews, training, schedules, and contract negotiations
• Managed a diverse team of professionals, fostering a positive work environment and high employee satisfaction
• Developed and implemented strategies to increase sales and profitability
• Cultivated strong relationships with clients, vendors, and partners to ensure long-term success and loyalty
• Monitored financial performance, set budgets and controlled expenses to provide financial stability and long-term organizational growth
• Managed budget development, forecasting, and financial reporting processes to track progress towards organizational objectives accurately
• Maximized efficiency by coaching and mentoring personnel on management principles, industry practices, company procedures, and technology systems
• Drove year-over-year business growth while leading operations, strategic vision, and long-range planning
• Formulated policies and procedures to streamline operations
• Implemented operational strategies and effectively built customer and employee loyalty
• Directed comprehensive sales efforts to exceed revenue targets consistently while maintaining customer satisfaction levels
• Developed and executed strategic plans for business growth and expansion, resulting in increased market share