Melissa Lemons
Idaho Falls,ID
Overview
35
35
years of professional experience
Work History
Credentialing Coordinator
Holistic Pain Management
Loveland, CO
07.2023 - Current
- Credentialing and onboarding new providers.
- Completing re-appointments for existing providers.
- Assisting providers in obtaining state licenses, DEA licenses and controlled substance licenses.
- Working knowledge of credentialing and licensing in nine different states.
- Work closely with facilities to ensure that credentialing and payor enrollments are processed in a timely manner.
- Maintains credentialing database.
- Attends weekly meetings with direct manager, regional managers, operations, and education to discuss barriers, goals, and status of credentialing and payor enrollments.
- Maintains a large volume of emails.
Credentialing Specialist
Gastro Health
Miami, FL
01.2022 - 06.2023
- Processed and submitted Initial and re-appointment applications for an exceptionally large gastroenterology practice.
- Followed all applications closely to ensure prompt processing.
- Verified that all licensures and certifications were current.
- Communicated with physicians, office staff, and medical staff offices to obtain necessary information.
- Updated credentialing database with pertinent information.
- Reviewed daily workflow report for assignments and deadlines.
- Attended weekly meetings for process improvement and team building.
- Maintain a large volume of emails.
Account Manager
STAT MEDCARE SOLUTIONS
Woodbridge, NJ
07.2021 - 12.2021
- Company Overview: STATMedcare provides facility credentialing and payer enrollment services to entities who seek assistance.
- Managed the credentialing for a multi-specialty office with 850 providers.
- With the assistance of my offshore team, I credentialed and enrolled providers with hospitals and insurance companies.
- STATMedcare provides facility credentialing and payer enrollment services to entities who seek assistance.
Medical Staff Coordinator
MOUNTAIN VIEW HOSPITAL
Idaho Falls, ID
03.2011 - 06.2021
- Supervised and mentored credentialing personnel.
- Processed credentialing applications for new and reappointed providers.
- Managed and maintained over four hundred providers credentials and privileges.
- Performed background checks.
- Managed the hospital's malpractice policies.
- Renewed various licensures.
- Managed medical students, nurse practitioners, and physician assistant's clinical rotations.
- Prepared for and conducted credentialing committee and board meetings.
- Collaborated closely with the chief of staff, hospital administrators, department heads, and office managers.
Billing Supervisor
GRAND TETON GASTROENTEROLOGY
Idaho Falls, ID
01.1994 - 03.2011
- Supervised and mentored billing personnel.
- Credentialed new and existing physicians with hospitals and insurance companies.
- Coded inpatient, outpatient, and office procedures/visits.
- Analyzed and identified billing issues.
- Wrote appeal letters to insurance companies when claims were not paid correctly.
- Managed fee schedules and contracts with insurance carriers, including Medicare and Medicaid.
- Performed internal chart audits.
- Certified Coder
Office Manager
HEATON CHIROPRACTIC HEALTH CLINIC
Idaho Falls, ID
09.1990 - 03.1994
- Greeted patients.
- Collected demographic and insurance information.
- Maintained patient log.
- Reconciled charges and payments.
Timeline
Credentialing Coordinator
Holistic Pain Management
07.2023 - Current
Credentialing Specialist
Gastro Health
01.2022 - 06.2023
Account Manager
STAT MEDCARE SOLUTIONS
07.2021 - 12.2021
Medical Staff Coordinator
MOUNTAIN VIEW HOSPITAL
03.2011 - 06.2021
Billing Supervisor
GRAND TETON GASTROENTEROLOGY
01.1994 - 03.2011
Office Manager
HEATON CHIROPRACTIC HEALTH CLINIC
09.1990 - 03.1994
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