Yanet Guada

Background

About Yanet Guada

Innovative, successful and driven healthcare and/or worker compensation professional with extensive years of experience within the Claims, Provider Networks, Specialty & Ancillary Vendors, Provider Relations & Data, Customer Service, Compliance and Grievance & Appeals. A position that will utilize and expand my knowledge, as well as my interpersonal skills to provide the highest level of service and strengthen the company's success. Major Accomplishments: Spearheaded the Information Systems staff to develop a claims scan system for the processed claims in order for all departments to view the processed claims on their desktops. Assisted the Decision Support team with the implementation of receiving and submitting electronic claims. Developed the crosswalk for HIPAA compliant adjust codes. Implemented an automated claims date and counting stamping machine. Improved employee morale, increased productivity and superseded monthly goal. Chairperson on behalf of the company at Grievance & State Hearings. Improved network relationships with clients as well as internal departments for savings and cost efficiencies. Negotiate and finalize contracts with vendors/providers. Build positive relationships with vendors, providers and clients. Increased Network penetration with each individual (Nationwide) claims office.