Avery Malone Email & Phone Number

Dandridge, Tn, Us

I was hired to turn around the underperforming credentialing activities and optimize credentialing efficiency for this medical billing company with 250 providers including Social Workers, Nurse Practitioners, and Physicians. During this time, I was recognized by the Credentialing Supervisor as a dedicated team member who completes all time-sensitive tasks accurately and within deadlines.• Corrected issues from providers not being credentialed, reviewing files to ensure required documentation was available, requesting documents from providers.• Assisted in creating new policy/procedures that improved credentialing performance, ensured provider files were up-to-date, and streamlined the process of managing provider data from newly hired clinicians. • Surpassed expectations by completing applications for providers to join insurance panels, verifying providers’ credentials during the onboarding process, and assisting providers with securing/renewing hospital privileges.

I was hired to turn around the underperforming credentialing activities and optimize credentialing efficiency for this national tele-psychiatry services company with 250 providers including Social Workers, Nurse Practitioners, and Physicians. During this time, I was recognized by the Credentialing Supervisor as a dedicated team member who completes all time-sensitive tasks accurately and within deadlines.• Corrected issues from providers not being credentialed, reviewing files to ensure required documentation was available, requesting documents from providers, and ensuring providers were added to the malpractice insurance.• Assisted in creating new policy/procedures that improved credentialing performance, ensured provider files were up-to-date, and streamlined the process of managing provider data from newly hired clinicians. • Reviewed malpractice insurance spreadsheets to maintain insurance compliance and ensure all providers were added to the policy that included working with providers to obtain state licensing within 30 days. • Surpassed expectations by completing applications for providers to join insurance panels, verifying providers’ credentials during the onboarding process, and assisting providers with securing/renewing hospital privileges.

I was recruited as Credentialing Specialist and was promoted to Credentialing Manager for this outsourced provider of managed care services for dermatology practices throughout the US. Managed credentialing activities for 400 providers and 2 outside vendors including assisting Physicians Assistants, Nurse Practitioners, and Physicians with licensing applications. • Created a new credentialing team in 2021 that included defining roles and providing support to achieve goals. • Turned around credentialing operations by reviewing provider files, ensuring applications had been submitted, and checking status to ensure providers were added to contracts. • Completed a major project in 2023 that resolved issues related to lack of data/information for credentialing applications that had been pending for several months. • Assisted in resolving several problems with credentialing operations, improving efficiency, establishing new processes, and leading/supervising two employees and an outside vendor. • Key leadership role during clinic acquisitions in 2022 that included researching/reviewing each new clinics’ credentialing and coordinating merger of newly acquired clinics with established internal credentialing practices. • Additionally responsible for using Verity Stream credentialing software, completing applications for providers to join insurance panels, ensuring applications were completed within deadlines, verifying provider credentials during onboarding process, and assisting with obtaining/renewing hospital privileges.

Nashville, Tennessee

I was recruited to perform credentialing functions for this national provider of healthcare services and population health management with 400 providers from multiple specialties including Registered Nurses, Nurse Practitioners, and Physicians in all 50 states. • Built a strong relationship with the Credentialing Supervisor and worked on special projects that improved credentialing process efficiency and aligned workload of regional team members. • Recognized for completing credentialing applications to ensure providers were credentialed in their first 30 days. • Used Echo One App credentialing software to maximize efficiency and manage a high-volume workload that included completing applications for providers to join insurance panels and assisting with licensing in multiple states.

Macomb, Illinois

I was recruited by this optometry billing consulting firm to assist in turning around and improving credentialing activities for 350 providers. • Ranked as the #1 top performer for completing the most applications and bringing in the highest revenue. • Implemented a new credentialing filing system that improved organization and access to provider files. • Initiated the company’s use of online credentialing that improved credentialing processing time. • Trained other credentialing staff on using Excel to track and improve efficiency and manage workload. • Assisted in creating a compliance manual that improved compliance with credentialing industry regulations.

Prairie City, Illinois

I managed business office operations and financial administration for residents of this rehab and healthcare facility with 20 employees. I balanced residents’ bank accounts, assisted residents in applying for state assistance/insurance, verified insurance eligibility for new residents, and managed staff during absence of Administrator.

Master Of Science (Ms), Health/Health Care Administration/Management

Bachelor'S Degree, Health/Health Care Administration/Management

Pre-Nursing Studies

Activities and Societies: Delta Phi Epsilon, Student Nursing Association