Melissa L. Murphy
Philo,IL
Summary
Experienced with managing provider networks and resolving provider-related issues. Utilizes effective communication and negotiation skills to foster positive relationships. Track record of enhancing provider satisfaction and ensuring compliance with organizational standards.
Overview
16
16
years of professional experience
Work History
PROVIDER RELATIONS SPECIALIST
Health Alliance
07.2023 - Current
- Liaison between healthcare organizations and Health Alliance.
- Answered provider inquiries via email, telephone and written correspondence.
- Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on-site enrollment opportunities.
- Facilitated smooth transitions when adding or removing providers from the network by coordinating communication between parties involved.
- Managed multiple projects simultaneously while maintaining attention to detail and meeting deadlines effectively.
- Increased efficiency by implementing automated processes for routine tasks related to provider relations management.
- Improved provider satisfaction by addressing concerns promptly and effectively.
- Played a key role in resolving complex billing issues between providers and payers.
- Developed strong relationships with providers, improving communication and collaboration.
- Collaborated with internal departments to resolve provider disputes in a timely manner.
- Mediated discussions between employer and employee representatives in attempt to reconcile differences.
- Managed provider relations mailbox by triaging inquiries, facilitating resolution of incoming requests and forwarding requests to appropriate parties.
SR CMA
Carle Health Organization
08.2019 - 07.2023
- Identify eligible Medicare patients in six primary care clinics, initiate contact to complete pre-visit screenings necessary for Medicare Annual Wellness Visit. Collaborate with Accountable Care Organization RN, Social Work and primary care staff. Utilize third-party database to ensure proper coding. Verify and enroll patients in Chronic Care Management program.
- Enhanced patient outcomes by providing knowledgeable education on procedures, medications, and other physician instructions.
- Promoted office efficiency, coordinating charts, completing insurance forms, and helping patients with diverse needs.
- Supported patients across various hospitals with both physical and emotional needs.
- Obtained client medical history, medication information, symptoms, and allergies.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging, and compassionate environment.
- Implemented care and efficiency improvements to support and enhance office operations.
SR CMA
Carle Physician Group
07.2009 - 08.2019
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Reviewed physician's calendar and scheduled patient appointments by telephone and in-person.
- Maintained a clean and safe clinical environment through diligent sterilization of medical equipment and adherence to infection control protocols.
- Supported clinic''s vaccination program by administering immunizations, tracking patient records, and providing information on vaccine schedules.
- Called and faxed pharmacies to submit prescriptions and refills.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens.
- Reduced wait times for patients by effectively coordinating physician schedules and exam room availability.
- Improved patient care by efficiently updating and maintaining electronic health records.
- Streamlined administrative processes by scheduling appointments, managing patient intake, and organizing medical documentation.
- Strengthened team collaboration by actively participating in staff meetings, sharing insights on process improvements, and offering assistance to colleagues when needed.
- Collaborated with other healthcare professionals such as nurses and pharmacists to coordinate optimal care plans for patients.
- Managed prescription refills requests promptly resulting in better medication adherence among patients.
- Supported successful treatment plans by preparing patients for examinations, discussing treatment options, and providing clear instructions on medication usage.
Education
Certification - Medical Assistance
Parkland Community College
Champaign, IL09-2014
High School Diploma -
Champaign Central High School
Champaign, IL05-2004
Skills
- Detail-oriented
- Task prioritization
- Self-motivated
- Teamwork and collaboration
- Problem-solving abilities
- Relationship building
- Adaptability and flexibility
- Effective communication
Accomplishments
- Co-chair on Unit partnership council
- Completed the Carle Leadership Academy
- Used Microsoft Excel to develop inventory tracking spreadsheets.
Timeline
PROVIDER RELATIONS SPECIALIST
Health Alliance
07.2023 - Current
SR CMA
Carle Health Organization
08.2019 - 07.2023
SR CMA
Carle Physician Group
07.2009 - 08.2019
Certification - Medical Assistance
Parkland Community College
High School Diploma -
Champaign Central High School
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