Tracy L. Robertson  

168 Breedlove Rd.

Nashville, NC  27856

 [Send email to request phone number] 67-5234

[Send email using form at bottom]

       

I Desire a challenging position utilizing my skills in planning, organization
and follow through, which will provide personal contact with a variety of
people.
 
Experience:

Sept 2006 - current        OptiCare Managed Vision – Rocky Mount, NC

Network Management Specialist – Provider Affairs Division

Responsible for provider (optometrist, ophthalmologist, optician) recruitment,
contracting and retention. Provide education and problem resolution to providers.
 Responsible for recruiting new providers through the entire process by making
initial contact, coordinating credentialing process between the provider and
Provider Maintenance Reps, and negotiating contracts within set parameters. 
Educate providers and their staff on company policies and procedures.  Resolve
all types of provider issues.  Ensure quality provider relations activities to
help retain providers. Attempt contract resolution upon termination notice from
providers. 
Develop provider network for vision insurance plans nationwide, specializing in
Medicaid and Medicare Managed Care Plans (client).  Coordinate contract
negotiations with providers, establishing reimbursements within acceptable
dollars to the provider and to the client. 
Assist in credentialing providers utilizing CAQH (Council for Affordable &
Quality Health Care), NPI Registry, UPIN Registry web portals as well as
recognize state specific Standardized Credentialing Processes.  Maintaining
and/or reconciling provider compliance in designated markets.  Monitoring
client’s established access standard for certain service areas and pro-actively
recruit providers in areas that are non-compliant to client’s access standard. 
Coordinating Out-of-Network care for members when there is not a provider within
the access standard. 
Administrative support of Network Development Department: Included but not
limited to, Signing and entering contracts with providers; loading participating
providers onto website for claims filing. 
Represent OptiCare Managed Vision at various Optometric Marketing Conferences
through out the United States. 
May 2002 – August 2005        Gardner O’Connor South, Inc. – Rocky Mount, NC

Executive Assistant/Office Manager

Administrative support to President/Owner. 
All aspects of human resources:  Payroll, Monthly Payroll Taxes (940,941,ESC),
State & Federal Tax Support. 
Inside Sales Manager, Inventory Control, Purchasing, Selling, Invoicing,
Billing, Budget Analysis. 
Jan 2002 – April 2002        Southeastern Acute Care Specialists – Rocky Mount,
NC

Emergency MD Assistant

Clinical documentation specialist for ECC Physicians at Nash General Hospital. 
General assistant to ECC Physicians with duties including but not limited to
patient care, physician directives to nursing staff, coordination of orders of
lab, radiology, testing, etc. 
  Help in improving patient care and patient flow in the Emergency Care Center 
 
May 2000–Nov. 2001 Boddie-Noell Enterprises, Inc. – Rocky Mount, NC

Executive Secretary

Administrative support to the President/CEO. 
Provide support to the IHFA: administrative duties, website design and
maintenance as well as assist in planning and communicating yearly meetings. 
Responsible for management of Corporate Contributions and the Corporate YMCA
program. 
Proficient in Microsoft Word, Excel and Power Point.  Certified to the advanced
level.  Also have certification for FrontPage 2000 Web design. 
 
Jan 1999-June 2000 Victory Church – Wilson, NC

Secretary

General office duties including but not limited to administrative support of the
Pastor, Board of Deacons and various other church departments. 
Responsible for promotions/public relations (radio, TV, newspaper) 
Design and edit monthly newsletter, design advertisements and maintained web
page. 
Managed Accounts Payable and Receivables. 
March 1995- March 1997 Boice-Willis Clinic - Rocky Mount, NC

Insurance Representative

Assisted patients in filing of medical insurance for five specialists 
Worked directly with HMO’s obtaining pre-certifications for surgical procedures
and investigated claims unpaid 
Responsible for the management of all liability, worker’s compensation and
disability claims. 
Cross trained in debt collection as well as provided relief for cashiers and
receptionists as needed. 
 

Personal/Professional Certifications/Diplomas:

High School Diploma – Sanderson High School, Raleigh NC - 1983

EMT-B State of NC – Nash Community College – Rocky Mount, NC - 2004

Notary Public – Nash Community College – Rocky Mount, NC  - 2002

Quicken Quick Books – Nash Community College – Rocky Mount, NC  -2002

Microsoft Outlook

Microsoft Access

Microsoft Word, Excel, Power Point Advanced Level

Seagate Crystal Reporting Software

Seagate Info Desktop

Risk Manager/AVIO Provider/Member Database

Credentialing Manager Software

Customer Service Interface Software (CSI)