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Skills

  • Cross-functional collaboration
  • Staff training
  • Audit preparation
  • Team management
  • Product promotions
  • Lead prospecting
  • Contract Management
  • Strategic planning
  • Revenue generation
  • Business operations

Work Experiences

  • Created standardized protocols for data entry.
  • Developed relationships with insurance carriers.
  • Enhanced data protection measures.
  • Collaborated with IT in transitioning provider file documentation to framework, improving data retrieval efficiency by 9%.
  • Collaborated with cross-functional teams to resolve escalated provider issues, improving resolution time from three years to 18 months on average.
  • Decreased audit discrepancies by 68%.
  • Enhanced data protection measures, ensuring all provider information adhered to procedure, resulting in Innovation Award for best practices.
  • Collaborated with IT on transitioning provider file documentation.
  • Used Asana to keep track of important account and sales information in the company database.
  • Assigned provider identification numbers to newly enrolled providers.

Summaries

  • Customer service, research, and conflict resolution skills are all excellent.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Schedule flexibility and the ability to travel up to 6% of the time.
  • Dedicated, articulate, and tenacious sales professional with a track record of exceeding goals through the use of strategy and advanced people skills.
  • Adept at collaborating with cross-functional teams.
  • Accomplished in mentoring teams while driving process improvements to ensure compliance with both federal and state healthcare regulations.
  • Addressed incomplete provider file information.
  • Bringing 16 years of experience in this field.
  • Aimed at continuous improvement.
  • Costs were consistently reduced while profits were increased.

Accomplishments

  • Played a key role in a major EHR system upgrade, ensuring proper integration of provider data with Workday, improving data flow by 17%.
  • Managed urgent escalations concerning provider records, achieving average issue resolution time of three years with full compliance.
  • Led communication efforts between physician practices and insurance carriers to expedite the verification process, reducing processing time by 48%
  • Instrumental in centralizing provider eligibility verification processes across multiple regions, driving down processing time by 61%.
  • Enhanced cross-functional communication between contracting, credentialing, and IT teams to expedite provider onboarding, cutting processing times from three years to several months.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Trained junior staff on best practices for provider file maintenance, reducing data entry errors by 22%.
  • Developed data report systems that allowed management to optimize provider network performance, resulting in framework.
  • Key participant in a cross-departmental initiative to digitize provider record-keeping, saving 4 hours in manual labor per month.
  • Executed high-quality credentialing file audits, meeting or exceeding regulatory requirements, with a record of procedure.

Affiliations

  • Certified Professional in Healthcare Risk Management (CPHRM)
  • Certified Professional in Healthcare Quality (CPHQ)
  • International Association of Administrative Professionals
  • Freemason
  • Jaycees
  • Provider Enrollment, Chain, and Ownership System (PECOS) Certification
  • Healthcare Information and Management Systems Society (HIMSS)
  • Toastmasters
  • American Hospital Association (AHA)
  • Society of Human Resource Management

Certifications

  • Certified Manager of Provider Enrollment (CMPEn) - Summit Group
  • Certified Healthcare Technology Specialist (CHTS), Northwind
  • Certified Healthcare Billing and Management Executive (CHBME) - Vantage
  • Certified Provider Credentialing Specialist (CPCS) by the National Association Medical Staff Services - Cedar Works
  • Certified Medical Staff Coordinator (CMSC) – Lakeside Partners
  • SHRM Certified Professional (SHRM-CP)
  • ServSafe
  • Certified Business Analysis Professional (CBAP)
  • Cisco Certified Network Associate (CCNA)
  • CompTIA A+ Technician

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