Dedicated professional with strong conflict resolution and performance evaluation skills. Experienced in credentialing processes and customer relationship management, committed to ensuring compliance and enhancing team productivity.
Overview
21
21
years of professional experience
Work History
Collections Lead/Credentialing Specialist
Premier Cardiovascular Center
Casa Grande
12.2004 - Current
Trained new team members on collections processes, enhancing team knowledge and consistency in best practices.
Monitored aging accounts to prioritize collection efforts effectively.
Developed strategies to enhance customer payment compliance.
Evaluated team performance, providing constructive feedback regularly.
Resolved customer disputes and escalated issues to management.
Generated reports on outstanding customer balances for upper management review.
Coordinated with departments to resolve conflicts or discrepancies in accounts.
Managed client communications through calls, emails, and website inquiries.
Managed provider credentialing processes for healthcare professionals and facilities.
Coordinated verification of licenses, certifications, and education for applicants.
Reviewed applications for completeness and compliance with regulatory standards.
Maintained accurate records in credentialing databases, supporting compliance and operational efficiency.
Guided providers on required documentation to ensure timely completion of credentialing processes.
Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
Processed re-credentialing applications for existing providers according to contractual requirements.
Provided support in responding to inquiries from external parties regarding credentialing information.
Completed enrollments into Medicaid, Medicare and private insurance plans.
Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
Interacted regularly with representatives from health plans and commercial payers regarding credentialing matters.
Served as a resource person for staff members seeking assistance in understanding complex regulatory requirements related to provider enrollment processes.
Maintained up-to-date records of credentialing statuses in database systems.
Provided guidance and support to new providers throughout the credentialing process.
Ensured strict confidentiality of provider information in accordance with HIPAA regulations.
Monitored expiration of licenses and certifications, notifying providers of renewal requirements.