Jody Porter Email and Phone Number

CREDENTIALING COORDINATOR, 2016 to PresentOversee all aspects of the credentialing and privileging processes for over 175 Healthcare Professionals. Manage an online credentialing database and maintain confidentiality of provider information. Maintain copies of current state licenses and certificates for all providers. Track and verify expiration dates for licenses and certificates to ensure timely renewals.  Recognized for building partnerships with Medicaid, the Ohio Behavioral Health Re-design, and third party administrators to improve operational efficiency, bill for more services, and ensure quality outcomes for medication and treatments. Established systems to monitor adherence to regulatory requirements, compliance guidelines, and organized patient information; implemented and led the process to save documents to a Docuware software

INTAKE COORDINATOR / MEDICAL RECORDS COORDINATOR, 2014 to 2016Reviewed clinical documentation and criteria policies to summarize and organize information for review. Processed agency home health referrals in an accurate and timely manner. Utilized independent judgment and confidentiality to plan, prioritize and organize the workload. Communicated with insurance providers to request patient information needed for files on hold or incomplete. Served as a liaison between company and patients/caregivers. Verified eligibility and benefits of all Medicare, Medicaid, and Managed Care Insurances.  Provided quality assurance on Medicare audits by verifying adherence to operational processes and documentation/notes/style guidelines; received a superior rating for the first Medicare audit. Focused on continuous improvement initiatives; developed a partnership with 5 insurance companies and increased business by 75%.

OFFICE COORDINATOR, 2013 to 2014Focused on operational excellence, administrative support, and patient communications for a home healthcare company. Prepared and tracked quarterly executive reports and referrals from Nursing Facilities. Managed heavy correspondence and a comprehensive database, scheduled patient home visits, and enforced HIPPA policies and procedures.  Collaborated with colleagues to identify ways to improve efficiency and establish office goals; focused on improving service provisions and insurance billing results. Built solid two-way partnerships with local hospitals and community agencies based on best practice, balanced with what is best for the office/patient and increased the number of referrals by 10%.

Pro-actively monitored and analyzed Worker’s Compensation claims for various companies in the state of Ohio. Managed specific aspects of claims to reduce the financial impact on the company and improve outcomes. Collaborated with the Ohio Bureau of Workman’s Compensation to prepare documents and review claims.  Utilized industry best practices to research claims and successfully negotiate settlements; proactively hired private investigators to observe employees on temporary total disability to evaluate suspected fraudulent claims.  Key player in leading company investigations for fraudulent activity; gained evidence and successfully proved claims for multiple employers. Selected to represent company at various community fundraisers.  Offered timely resolution of moderately complex claim problems or escalations via phone or in-person