• Assisted the Manager of Payer Reimbursement and Analytics and Leadership by providing operational and tactical support in all aspects of the revenue cycle. • Responsibilities include A/R research and analysis, charge capture auditing, payment posting and collections, third-party billing operations, vendor management, process improvement, client management, reporting, and other duties as assigned.• Assisted in the creation and implementation of all special billing rules… Show more • Assisted the Manager of Payer Reimbursement and Analytics and Leadership by providing operational and tactical support in all aspects of the revenue cycle. • Responsibilities include A/R research and analysis, charge capture auditing, payment posting and collections, third-party billing operations, vendor management, process improvement, client management, reporting, and other duties as assigned.• Assisted in the creation and implementation of all special billing rules. • Monitored existing special billing rules for accuracy and execution. • Facilitated presentations/meetings at client sites; education, process, training, and industry related content. Show less

• Account managed and supported 20+ hospitals, clinics, and pharmacies with over 1500+ internal professionals.• Administered the review, process, and enrollment of Physicians and Allied Health Professionals in Medicare, Medicaid, and Commercial Health Plans nationwide according state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements. • Maintained an internal and online database of Physicians and Allied Health… Show more • Account managed and supported 20+ hospitals, clinics, and pharmacies with over 1500+ internal professionals.• Administered the review, process, and enrollment of Physicians and Allied Health Professionals in Medicare, Medicaid, and Commercial Health Plans nationwide according state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements. • Maintained an internal and online database of Physicians and Allied Health Professional files including personal information, privileges, malpractice changes, and enrollment information. Liaison between various departments within the business office. • Partnered with hospital and clinical sites and their billing leaders to communicate process information.• Facilitated presentations/meetings at client sites; education, process, training, and industry related content. Show less

• Reviewed, processed, and enrolled Physicians and Allied Health Professionals in Medicare, Medicaid, and Commercial Health Plans nationwide according state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements. • Created procedures for the new hire process, which included collaboration with department managers, support staff, and fellow enrollment specialists. Created training materials for new process. • Team member… Show more • Reviewed, processed, and enrolled Physicians and Allied Health Professionals in Medicare, Medicaid, and Commercial Health Plans nationwide according state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements. • Created procedures for the new hire process, which included collaboration with department managers, support staff, and fellow enrollment specialists. Created training materials for new process. • Team member on various department projects to improve operations, communications, and compliance. Show less

• Account managed and supported 6+ client sites with over 100+ internal professionals.• Reviewed, processed, and enrolled Radiologist and Nurse Practitioners in Medicare, Medicaid, and Commercial Health Plans nationwide according state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements.• Maintained internal database of Physicians and Health Professional files including address, privilege, malpractice changes, and… Show more • Account managed and supported 6+ client sites with over 100+ internal professionals.• Reviewed, processed, and enrolled Radiologist and Nurse Practitioners in Medicare, Medicaid, and Commercial Health Plans nationwide according state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements.• Maintained internal database of Physicians and Health Professional files including address, privilege, malpractice changes, and enrollment information. Liaison between various departments within the business office.• Streamlined procedures for enrollment process, created tracking system, updated file system, and educated Medicare processes to billing team. Show less

• Reviewed, processed, and certified credentialing and re-credentialing of health plan providers according to NCQA requirements, state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements.• Project managed the credentialing workflow to ensure completeness and accuracy of information, data quality, and entry for all completed applications to meet credentialing deadlines of behavioral health providers.• Conducted cross… Show more • Reviewed, processed, and certified credentialing and re-credentialing of health plan providers according to NCQA requirements, state guidelines, federal laws, and company policy and procedures while adhering to confidentiality of information requirements.• Project managed the credentialing workflow to ensure completeness and accuracy of information, data quality, and entry for all completed applications to meet credentialing deadlines of behavioral health providers.• Conducted cross functional training and established best practices in areas of licenses; DEA; CDS; and education; NPDB and HIPDB; AMA; IRS; ANCC; ABMS. Show less