Eric Riddick

About Eric Riddick

I am a Claims Processor Sr Associate at Cigna-HealthSpring, with over seven years of experience in the healthcare industry. I specialize in processing, analyzing, and resolving claims for Medicare, Medicaid, and commercial insurance, ensuring timely payment and customer satisfaction. I also have a strong background in credentialing and educating providers on CMS guidelines and policies, as well as assisting them with claims processing issues. I have consistently exceeded production goals by 99% while maintaining quality, and have contributed to process improvement and training initiatives. I have excellent communication, problem-solving, and teamwork skills, and I am always eager to learn new skills and take on new challenges. My goal is to continue to provide high-quality service and support to Cigna-HealthSpring and its customers, and to advance my career in the healthcare industry.

Experience

1. Provider Enrollment Analyst Credentialing

   Soft Source, Inc

   Aug 2015 — Present

   Review, research, and analyze provider enrollment applications for Medicare Parts A&B, DME and Medicaid. Approved and denied applications according to CMS guidelines. Talked to and advised providers via email, phone and fax on enrollment in reference to CMS guidelines. Assisted in preparing and coordinating provider information to / from managed care quality committees and other internal departments and / or external entities.Exceeded production goals by 99% while maintaining quality.Maintained credentialing database while tracking all direct provider contract data.Performed primary and secondary source verifications of credentials according to departmental policy.Maintained all medical license, Drug Administration and malpractice insurance for physicians and mid-level providers.Ensured compliance with national standards of quality organizations. Used systems:Onbase client, MCS, Xcelys, AMISYS, FACETS 5.01/5.10, Intelex, PEGA, PMDB, Outlook, Microsoft Excel, Microsoft Office, Power Point, FISS

Education

• Guilford Technical Community College

  Associate's degree

• Continental Academy

  High School Diploma, High School/Secondary Diplomas and Certificates

  2003 — 2007

• Guilford Technical Community College

  N/A, Liberal Arts and Sciences/Liberal Studies

  2005 — 2007