Sandra Gordon Email & Phone Number

Woodstock, Ga, Us

Woodstock, Ga, Us

Credentialing Onboarding Lead (February 2022-Present)• Oversee new provider onboarding process to meet credentialing and enrollment deadlines, including timely primary source verifications• Prepare Medicaid and Commercial applications and track all progression steps in internal database• Ensure Team meets or exceeds individual productivity metrics, quality and timeliness standards• Ensure internal support queue is worked daily by Enrollment Specialists• Conduct Quality… Show more Credentialing Onboarding Lead (February 2022-Present)• Oversee new provider onboarding process to meet credentialing and enrollment deadlines, including timely primary source verifications• Prepare Medicaid and Commercial applications and track all progression steps in internal database• Ensure Team meets or exceeds individual productivity metrics, quality and timeliness standards• Ensure internal support queue is worked daily by Enrollment Specialists• Conduct Quality Audits on New Doctor Enrollment Activities• Conduct weekly workload discussions with team members to monitor production• Review and prepare packets in accordance with NCQA Standards for review/submission to ICC• Host weekly review with recruiting team and field leadership to identify and address any potential obstacles in onboarding• Assist team in elevating issues to Director of Payor Relations when Enrollment Specialists need help with payor issues• Runs queries, generates reports and credentialing document verification requests • Exceptionally organized with a demonstrated ability to be disciplined in the face of multiple priorities and questions, pro-active problem-solver• Maintain professional interactions with providers but also with business executives and remote office staff membersCredentialing & Enrollment Specialist II (June 2021 – February 2022)• Generated Medicaid and Commercial applications, ensuring accuracy and correct documentation, before submission of initial enrollment and recredentialing • Tracked all enrollment progression steps in internal credentialing database and communicated to field leadership• Closely monitored application statuses to ensure provider start not affected• Identified expiring licensures, board certifications, and other required documents necessary for enrollment and recredentialing• Worked internal queue to address credentialing inquiries generated from Accounts ReceivableCredentialing Onboarding Specialist (February 2021 – June 2021) Show less

 An integral part of creating a clinic's first impression by greeting and welcoming patients Partnered with the providers and team to implement Heartland Dental systems to optimize office potential Managed front office duties, including answering phones, checking office mail and email, communicating with patients and insurance companies Utilized Dentrix for patient scheduling and records Scheduled and confirmed appointments for multiple providers in the office File… Show more  An integral part of creating a clinic's first impression by greeting and welcoming patients Partnered with the providers and team to implement Heartland Dental systems to optimize office potential Managed front office duties, including answering phones, checking office mail and email, communicating with patients and insurance companies Utilized Dentrix for patient scheduling and records Scheduled and confirmed appointments for multiple providers in the office File patient insurance claims and follow up on outstanding claims, verification of benefits and explanation of coverage Posted insurance and patient payments and processed accounts receivables Reviewed treatment plan fees and payment options with patients Show less

Marietta, Georgia, United States

 Coordinated regular meetings with regional Operations, Clinical, Finance and HR leadership to ensure the provider schedule is appropriately confirmed and communicated for over 250 dentists in 67+ dental offices spanning 10+ states Served as the company’s “point person” for questions related to doctor schedules and coverage to allow for maximum clinic operations Communicated through regular reports, and ad hoc as necessary, throughout the organization Worked with the Licensing &… Show more  Coordinated regular meetings with regional Operations, Clinical, Finance and HR leadership to ensure the provider schedule is appropriately confirmed and communicated for over 250 dentists in 67+ dental offices spanning 10+ states Served as the company’s “point person” for questions related to doctor schedules and coverage to allow for maximum clinic operations Communicated through regular reports, and ad hoc as necessary, throughout the organization Worked with the Licensing & Credentialing teams to ensure doctors were able to perform in compliance with relevant regulatory requirements Assisted in provider payroll management and payroll administration to ensure accurate and timely bi-weekly reports Assisted in HR operations while acting as a liaison between the dentists and Human Resources department Participated in task force initiatives to broaden understanding of other department impact on clinic operations An integral part of the dentist onboarding team to promote a smooth start Exceptionally organized with a demonstrated ability to be disciplined in the face of multiple priorities and questions, pro-active problem-solver Maintained relationship building with medical professionals but also with business executives and remote office staff members Prior to transitioning credentialing out of this role, I also performed the following responsibilities to include, but not limited to (August 2005 – June 2008) : o Processed incoming dental providers applications and maintained existing contract and credentialing documents to ensure records and documents were complete, accurate and compliant o Maintained hard copy and electronic credentialing files o Responded to internal and external credentialing status and/or term request o Developed and presented regular reports to the Vice President of Compliance Experienced in all Microsoft Office software packages, ADP/Vantage, IntelliSoft and Boomerang Show less

Marietta, Georgia, United States

CBO/MSO Manager, CBO Administration (October 2000 to August 2005) Managed special projects staff Produced ad-hoc reports for upper-level/office management analyzing performance Trained providers/management/users monthly on the system reporting tools Implemented and trained users on new physician office scanning product (HBF) Participated in internal systems development and software application projects Urgent Care front office experience –… Show more CBO/MSO Manager, CBO Administration (October 2000 to August 2005) Managed special projects staff Produced ad-hoc reports for upper-level/office management analyzing performance Trained providers/management/users monthly on the system reporting tools Implemented and trained users on new physician office scanning product (HBF) Participated in internal systems development and software application projects Urgent Care front office experience – scheduling & registration Trained in InfoMine/InfoCure, VitalWorks, Monarch, and Crystal report writers Promoted to CBO/MSO Manager from Financial Analyst Business Manager, WPG Bone Densitometry (December 2003 to August 2005) Manage radiology technicians Evaluate patient volume to determine site scheduling Responsible for patient account balance follow up and training Consult with practice management and referral coordinatorsFinancial Analyst, Strategic Development (October 1999 to September 2000) Performed analysis to evaluate trends and budgetary objectives Processed monthly physician reimbursement  Developed profitability tools to identify physicians’ utilization of medical services  Developed positionAdministrative Assistant, Administration (March 1999 to February 2000) Developed 150 standardized job descriptions for clinical personnel throughout health system Supported the Vice President of Nursing Provided general office management Trained in ESI and Kronos Promoted to Financial Analyst role after 8 months in Assistant positionDepartment Secretary, Human Resources (May 1998 to March 1999) Updated/maintained application database Processed all incoming applications Participated on a task force team to develop standardized system job descriptions Supported the Human Resources department and the Director of Human Resources Provided general office management Show less