Adrianne Rossall
Pflugerville
Summary
Diligent Credentialing Specialist with a strong background in credentialing processes and compliance management, recognized for effectively managing credentialing for diverse healthcare providers while ensuring strict adherence to regulatory standards. Proven expertise in meticulous documentation and fostering effective communication with credentialing entities enhances operational efficiency and supports organizational integrity. Committed to maintaining high-quality standards and streamlining processes to facilitate optimal healthcare delivery. A proactive approach to problem-solving and a deep understanding of industry regulations drive continuous improvement in credentialing practices.
Overview
22
22
years of professional experience
Work History
Credentialing Specialist
Enable Dental
Austin, TX
04.2024 - Current
- Evaluated provider applications for compliance with regulatory standards
- Coordinated credentialing processes to enhance operational efficiency
- Developed and maintained comprehensive provider databases
- Facilitated communication between providers and internal departments
- Streamlined credentialing workflows, reducing processing times
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Conducted audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
- Enhanced credentialing processes by streamlining documentation and verification procedures.
Treatment Coordinator
Enable Dental
Austin, TX
07.2021 - Current
- Assist dentist in helping patients determine optimal treatment options
- Function as team leader and organized all treatment and placement activities
- Thoroughly study patients' x-rays to help determine best treatments for dental ailments and conditions
- Assure regulatory compliance and professionalism across patient service
- Identify potential problems and patient care trends
- Compile and maintain medical charts and reports in complex digital databases
- Collaborate with nursing staff to advocate for individual patient needs and insurance coverage
- Provide administrative support for patient care staff
- Establish strong work network by building professional relationships with physicians and fellow employees
New Patient Coordinator
Dr. Michael Williamson
Austin, TX
05.2016 - 07.2018
- Assured regulatory compliance and professionalism across patient service
- Scheduled evaluations and procedures for patients
- Provided administrative support for patient care staff
- Liaised effectively with patients, doctors and staff members, assessing medical charts and promoting high level of communication and interaction
- Demonstrated flexibility during changes to patient care practice
- Completed insurance verifications and claim forms for patient intake and processing
- Processed patient intake information and updated medical records prior to treatment
- Received and routed care team messages and documents to appropriate staff
- Communicated with patients to ensure quality of care and develop care plans
- Troubleshot and resolved complex customer service issues to enhance patient and family experience
- Established strong work network by building professional relationships with physicians and fellow employees
- Participated in subordinates' tasks to facilitate productivity or help overcome difficulties
- Interpreted and explained work procedures and policies to brief staff
Account Coordinator
Round Rock Dental Group
Round Rock, TX
02.2012 - 03.2015
- Thoroughly studied patients' x-rays to help determine best treatments for dental ailments and conditions
- Made appointments, contacted patients for follow-ups, coordinated with insurance companies and handled billing issues
- Coordinated payment with insurance companies and discussed dental benefits with patients
- Assured regulatory compliance and professionalism across patient service
- Communicated with patients to ensure quality of care and develop care plans
- Processed patient intake information and updated medical records prior to treatment
- Held interviews with patients to hear concerns, gather health history and understand objectives
- Assisted dentist in helping patients determine optimal treatment options
- Conducted financial consultations with patient and set up payment plans
Office Manager
Dr. Blake Synowski
El Cajon, CA
06.2004 - 10.2011
- Used judgment and initiative in handling confidential matters and requests
- Handled scheduling and managed timely and effective allocation of resources and calendars
- Maintained impeccable office organization to support efficiency, professionalism and performance objectives
- Monitored payments due from clients and promptly contacted clients with past due payments
- Oversaw receiving and organizing correspondence, answering and forwarding calls and creating business letters and records
- Sustained office efficiency by implementing and planning office systems, equipment procurement and layouts
- Implemented and maintained company protocols to facilitate smooth daily activities
- Remained calm and professional in stressful circumstances and effectively diffused tense situations
- Completed thorough opening, closing and shift change functions to maintain operational standards each day
Education
Registered Dental Assistant - Certificate of Competency, Dental Assistant/RDA
San Diego County Regional Occupational Program
San Diego, CA05.2001
Skills
- HIPAA compliance
- Provider enrollment
- Data management
- Credentialing oversight
- Provider relations
- Application coordination
- Data acquisition
- Document review
- Application management
- Background checks
- License verifications
- Credentialing documentation
- Credential verification
- Facility credentialing
- Solo practitioner credentialing
Timeline
Credentialing Specialist
Enable Dental
04.2024 - Current
Treatment Coordinator
Enable Dental
07.2021 - Current
New Patient Coordinator
Dr. Michael Williamson
05.2016 - 07.2018
Account Coordinator
Round Rock Dental Group
02.2012 - 03.2015
Office Manager
Dr. Blake Synowski
06.2004 - 10.2011
Registered Dental Assistant - Certificate of Competency, Dental Assistant/RDA
San Diego County Regional Occupational Program