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Provider Enrollment Coordinator resume examples

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Skills

  • Supervision
  • Handling discrepancies in enrollment
  • Enrollment database management
  • Accuracy in provider applications
  • Operational improvement
  • Application accuracy improvement
  • Managing high-volume enrollment cases
  • Application follow-up methodology
  • Data integrity
  • Process optimization

Work Experiences

  • Collaborated with the IT team.
  • Completed onboarding over two years.
  • Consolidated provider files and documents.
  • Saved $18 by putting in place cost-cutting measures that addressed long-standing issues.
  • Achieved a measurable 65% gain in efficiency.
  • Authored enrollment policy updates.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Coordinated communication with internal departments.
  • Achieved Innovation Award for exceptional performance.
  • Processed 9 invoices and mailed documentation to clients each 6 months.

Summaries

  • Collaborated with IT departments to implement automated systems that decreased manual data entry by 65%, boosting accuracy and efficiency across provider applications.
  • Achieved timely enrollments.
  • Empathy, dependability, and enthusiasm for customer satisfaction.
  • Working with stressed, confused, and upset people who need benefits information and supportive guidance to navigate standard systems is one of my specialties.
  • Collaborative Insurance Verification Specialist with a track record of establishing rapport with patients and maintaining data integrity.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Exceptional organizational skills and meticulous attention to detail.
  • Recognized on a regular basis for outstanding performance and contributions to the Human Resources industry's success.
  • Dedicated to learning, growing, and succeeding in Human Resources.

Accomplishments

  • Reduced enrollment backlog by 61% by identifying bottlenecks in the application process and proposing effective solutions.
  • Optimized provider database management using HubSpot, resulting in a 36% increase in data integrity and reducing administrative workload.
  • Developed and implemented data validation protocols that improved application accuracy, increasing first-pass enrollment approvals by 70%.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Ensured all provider credentialing met CMS requirements, avoiding delays or rejection of claims reimbursement by maintaining a 60% success rate.
  • Integrated third-party payer portals into daily operations, reducing submission times for provider enrollments and improving approval rates by 35%.
  • Streamlined the provider enrollment process, decreasing time-to-credential by 40% through optimized workflows and enhanced data validation techniques.
  • Provided exceptional customer service to providers, assisting with enrollment and re-credentialing questions, improving satisfaction rates by 45%.
  • Improved accuracy in provider enrollment applications by 44% through rigorous cross-checks and adherence to industry compliance standards.
  • Collaborated with team of 12 in the development of framework.

Affiliations

  • Medicare Learning Network (MLN)
  • National Association Medical Staff Services (NAMSS)
  • International Association of Administrative Professionals
  • Jaycees
  • Affordable Care Act Payer Collaboration Networks
  • Healthcare Financial Management Association (HFMA)
  • Association for Computing Machinery
  • Association for Professionals in Infection Control and Epidemiology (APIC)
  • American College of Medical Practice Executives (ACMPE)
  • Council for Affordable Quality Healthcare (CAQH)

Certifications

  • Professional Association of Health Care Office Management (PAHCOM) Certification – 2020
  • ServSafe
  • Salesforce
  • Credentialing Coordinator Certification (CCC) Cedar Works, 2019
  • Practice Management Institute (PMI) Certified Enrollment Management Specialist (CEMS) 2017
  • Healthcare Management Certificate, standard, 2022
  • CompTIA Network+
  • Certified Professional in Healthcare Quality (CPHQ) - Northwind 2024
  • Project Management Professional (PMP)
  • Certified Outpatient Coder (COC) by AAPC 2020

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