Jenna Smith Email & Phone Number

Fort Myers, Fl, Us

- Lead payer credentialing, enrollment, and re-credentialing processes for over 20 managed care plans, including Medicare, Medicaid, and vision plans, across multiple states, while maintaining ongoing communication with payers to ensure accuracy and timeliness of credentialing efforts and providing updates to providers and office staff regarding participation status and required documentation.-Solely manage credentialing for over 50 providers while maintaining board certificates, medical, Drug Enforcement Administration (DEA), Controlled Dangerous Substance (CDS) licenses; CAQH, NPPES, and PECOS profiles; and hospital initial and reappointment compliance.-Direct provider onboarding and due diligence procedures, obtaining and verifying all necessary legal and credentialing information through regular interactions with new providers through email, phone calls, and video meetings.-Identify and rectify discrepancies in participation status, resolving issues to prevent claim denials and enhance the payer network by identifying contracts and networks.

- Expertly completed and submitted credentialing and re-credentialing applications for over 30 managed care payers, meticulously tracking and following up on status, effective dates, and lines of business.- Maintained effective communication with payer representatives across 17 states to ensure seamless enrollment processes and kept clinic offices consistently informed of credentialing status.- Created comprehensive Physician Reference Guides for new providers, streamlining the completion of credentialing applications with thorough due diligence.- Conducted detailed investigations into credentialing status conflicts, securing necessary information to rectify discrepancies and prevent coverage lapses.

-Executed comprehensive analysis and management of provider data in Microsoft Access and various online databases, ensuring precise integration with insurance platforms such as CAQH, LexisNexis, and OneHealthPort.-Designed and implemented a digital filing system to transition critical confidential physical files to electronic formats, enhancing accessibility for team members.-Developed and provided Physician Reference Guides for new providers, facilitating the efficient distribution of essential information to team members.-Managed the department’s inventory, overseeing procurement, requisition, and receipt of supplies to ensure efficient operations.