Lovie Taylor
Union City
Summary
Provider Enrollment Specialist leveraging over 11 years of experience to streamline enrollment processes across healthcare settings. Proven track record of improving compliance and data integrity while fostering collaboration with providers. Committed to delivering innovative solutions that enhance operational readiness and provider satisfaction.
Overview
12
12
years of professional experience
Work History
PROVIDER ENROLLMENT
Sound Physicians
Nashville (Remote)
06.2025 - 03.2026
- Liaised with insurance companies to finalize provider enrollment, enhancing operational readiness and billing capabilities.
- Reviewed provider enrollment applications for compliance with state and federal regulations.
- Resolved discrepancies in provider enrollment to ensure data accuracy and integrity.
- Monitored government regulation changes impacting healthcare provider enrollment processes.
PROVIDER ENROLLMENT REPRESENTATIVE
BroadPath Healthcare Solutions
Tucson (Remote)
09.2023 - 12.2024
- Streamlined provider enrollment processes across healthcare networks to enhance accuracy and efficiency.
- Coordinated with providers to gather essential enrollment information for smoother onboarding.
- Reviewed documentation for regulatory compliance, ensuring timely enrollments and minimizing errors.
- Utilized enrollment management systems to effectively track provider applications.
- Conducted audits of enrolled providers to verify data accuracy and maintain integrity.
PROVIDER ENROLLMENT REP
Noridian Healthcare Solutions, LLC
North Fargo (Remote)
05.2022 - 08.2023
- Streamlined provider enrollment process for healthcare providers and facilities.
- Coordinated cross-departmental efforts to resolve enrollment issues promptly.
- Reviewed and verified application documents for compliance and accuracy.
- Ensured timely submission of enrollment applications to federal programs.
- Communicated with providers to gather necessary documentation efficiently.
REIMBURSEMENT SPECIALIST
CareMetx, LLC (TalentBridge)
Charlotte (Remote)
12.2021 - 02.2022
- Verified patient eligibility and insurance coverage for prescribed treatments.
- Resolved technical reimbursement inquiries for providers' billing and coding staff to ensure compliance.
- Coordinated with healthcare providers to efficiently address billing inquiries.
- Maintained comprehensive records of reimbursement transactions and communications for accurate processing.
- Drafted documents according to payer guidelines and submitted them to relevant parties.
PATIENT ACCESS SPECIALIST
Lash Group (Talentbridge)
Charlotte (Remote)
11.2020 - 05.2021
- Streamlined patient registration and verification to ensure efficient access to healthcare services.
- Maintained accurate patient information in electronic health records for data integrity.
- Resolved registration challenges, including eligibility verification and authorization issues.
- Collaborated with healthcare teams to enhance service delivery and improve patient care.
- Monitored compliance with HIPAA regulations to safeguard patient privacy and confidentiality.
- Addressed patient inquiries to improve overall service effectiveness.
- Identified and rectified enrollment problems to facilitate smoother processes.
MEMBER SERVICE REPRESENTATIVE
Aliera Companies
Sandy Springs
05.2019 - 01.2020
- Managed high call volumes while maintaining quality customer service standards to meet member needs promptly.
- Addressed inquiries regarding healthcare plans and benefits, enhancing member understanding and satisfaction.
- Resolved issues by coordinating with various departments to deliver effective solutions.
- Processed applications and updated account information efficiently to ensure accuracy.
- Handled conflicts and challenging situations by utilizing internal resources for effective resolutions.
COMPLIANCE AUDITOR
Homedepot Call Center (Apex Systems)
Smyrna
12.2018 - 03.2019
- Analyzed client operation risks to proactively address compliance issues.
- Reviewed operational processes, ensuring regulatory adherence and minimizing risk.
- Assisted in preparing audit reports that offered insights for management decisions.
- Maintained documentation of audit processes and findings for future reference.
- Participated in special projects focused on enhancing compliance standards.
CHARGEBACK/MEDICAID COORDINATOR
UCB Pharma Inc (Advanced Recruiting Partners)
Smyrna
06.2014 - 03.2018
- Analyzed chargeback submission data to ensure compliance with contractual agreements.
- Developed and implemented Medicaid eligibility processes for clients.
- Created and analyzed Excel spreadsheets using V-Lookup and pivot tables for efficient Medicaid invoice comparisons.
- Managed relationships with group purchasing organizations and wholesalers to optimize contract pricing.
- Delivered detailed membership reports to group purchasing organizations, identifying active members needing intervention.
- Processed class of trade and tier-level changes for qualified members in SAP CRM and CAQH quarterly.
Education
CYBER AND NETWORK DEFENSE - Information Technology
University of Phoenix-Arizona
Phoenix, AZ06-2025
ASSOCIATES OF SCIENCE - CRIMINAL JUSTICE ADMINISTRATION
International Institutes of The Americas
Albuquerque, NM12-2006
ASSOCIATES OF APPLIED SCIENCE - PARALEGAL
Metropolitan College of Court Reporting
Albuquerque, NM05-2002
Skills
- Provider enrollment
- Credentialing procedures
- Credentialing databases
- Medicaid Medicare
- HIPAA compliance
- Excel and Workspace
- Attention to detail
- Multitasking and problem-solving
Timeline
PROVIDER ENROLLMENT
Sound Physicians
06.2025 - 03.2026
PROVIDER ENROLLMENT REPRESENTATIVE
BroadPath Healthcare Solutions
09.2023 - 12.2024
PROVIDER ENROLLMENT REP
Noridian Healthcare Solutions, LLC
05.2022 - 08.2023
REIMBURSEMENT SPECIALIST
CareMetx, LLC (TalentBridge)
12.2021 - 02.2022
PATIENT ACCESS SPECIALIST
Lash Group (Talentbridge)
11.2020 - 05.2021
MEMBER SERVICE REPRESENTATIVE
Aliera Companies
05.2019 - 01.2020
COMPLIANCE AUDITOR
Homedepot Call Center (Apex Systems)
12.2018 - 03.2019
CHARGEBACK/MEDICAID COORDINATOR
UCB Pharma Inc (Advanced Recruiting Partners)
06.2014 - 03.2018
CYBER AND NETWORK DEFENSE - Information Technology
University of Phoenix-Arizona
ASSOCIATES OF SCIENCE - CRIMINAL JUSTICE ADMINISTRATION
International Institutes of The Americas
ASSOCIATES OF APPLIED SCIENCE - PARALEGAL
Metropolitan College of Court Reporting