I am responsible for multiple group practices, the largest practice being 143 providers, and 54 locations. I currently work with practices in the state of Florida, Indiana, Louisiana, Maryland, North Carolina, Ohio and Washington.Coordinate, develop, monitor, and maintain all aspects of the credentialing process.Update and maintain all applicable provider numbers in the system database-CAQH, PECOS, and NPPES.Maintain a network of relationships with third party and government payers and the regional sales staff located nationwide.Ensure that all licensure, certifications and accreditations processes and procedures are completed in a timely manner. Collaborated and coordinated with physicians, and administrative representatives. Monitor all work in process ongoing and update new clients weekly with a progress report.Interprete, analyze and model managed care and commercial contracts.Interact with internal and external customers and ensure value is delivered and customer satisfaction is achieved.

* Collaborate with physician owner to gain complete understanding of project goals and objectives.* Provided consultation and training support to medical office staff regarding RCM operation.* Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS database * Update providers’ CAQH database file timely according to the schedule published by CMS* Increased revenue by 30% first year by timely filing of claims, patients statements weekly, copay/ coinsurance collections. * Analyzed operating expenses for a reduction of 5% by negotiating new service contracts, & effective staffing

* Resolve billing issues by applying knowledge, completing in-depth research and submit appeals for denied claims* Conduct insurance verification and pre-authorization, code optical procedures & manage patient charts* Reconcile codes against services rendered* Check claims coding for accuracy with ICD-10 standards* Reconcile financial accounts using Revolution EHR software, post payments for medical services* Apply HIPAA privacy and security regulations while handling patient information* Input details into accounts & track payments* Review account information to confirm patient and insurance information is accurate and complete* Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases * Update each providers CAQH database file timely according to the schedule published by CMS

* Contracted to credential and contract with payers for three providers.

* Supported entire practice's staff, which boosted efficiency and improved overall process flow* Motivated staff by offering direction & providing constructive feedback* Created & implemented policies and procedures for effective practice management* Communicated with patients with compassion while keeping medical information private* Ordered supplies needed and kept tabs on inventory levels* Complied with OSHA and HIPAA regulations* Coordinated financial operations, budgeting, accounting, expenses and financial reporting* Consulted with physicians to develop business strategy.* Collaborated with multi-disciplinary staff to improve overall patient care* Directed, supervised and evaluated medical, clerical or maintenance personnel* Recruited, hired and trained new medical & clerical staff* Facilitate preparation and submission of employee payroll* Physician credentialing, license renewal, and reappointment's, insurance contracting & negotiating

* Created and implemented policies and procedures for effective practice management.* Physician credentialing, license renewal, and reappointment, insurance contracting & negotiating * Successfully managed the implementation of new practice management/ medical billing software* Recruited and hired two physicians for the practice, interviewed, contracted, and educated regarding the practice * Facilitate preparation and submission of employee payroll* Project Management of relocating the office