Ronda Wasson
Gap
Summary
Dynamic professional with a proven track record at United Healthcare, excelling in project management and problem-solving. Spearheaded a Six Sigma project that achieved $1.1M in savings while ensuring quality in Out of Network setups. Recognized for exceptional communication skills and meticulous attention to detail in supporting regulatory appeals.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Senior Provider Relations Representative
United Healthcare
05.2020 - Current
- Provide support to the Out of Network Appeals team with regard to Department of Insurance (DOI), Regulatory and Legal appeals.
- Maintain weekly Out of Network Defect Report for the purposes of identifying any group setup issues.
- Provide backup support to Appeals team as needed for reviews of Federal/State Surprise Billing issues.
- Provided exceptional customer service to providers during the credentialing process, ensuring a smooth experience for all parties involved.
Out of Network Associate Project Manager
United Healthcare
12.2006 - 05.2020
- Led and completed a Six Sigma Green Belt project that generated $1.1M in savings. Managed/Controlled Project Scope/Timelines and Resources.
- Oversight and management of Admin Services Only (ASO) Intake tracking process to assure quality of ASO Out of Network Program setups. Includes working with internal business partners to make corrections as needed.
- Oversight and management of Client Billing Par/Nonpar Review process to assure quality and efficiency of ASO client billing details.
Education
MBA - Business Administration
University of Phoenix
Phoenix, AZ08-2005
Skills
- Problem-solving
- Time management
- Attention to detail
- Reliability
- Excellent communication
- Effective communication
- Adaptability and flexibility
- Project management
Certification
- Six Sigma Green Belt Certification - 2010
Timeline
Senior Provider Relations Representative
United Healthcare
05.2020 - Current
Out of Network Associate Project Manager
United Healthcare
12.2006 - 05.2020
MBA - Business Administration
University of Phoenix
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