Alisha Trevino
Forrest City,AR
Summary
Reliable and accomplished Credentialing Specialist with over 20 years of experience in the healthcare industry . Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
22
22
years of professional experience
Work History
Billing/Credentialing Specialist
Changes Behavioral Health
Wynne, AR
09.2022 - Current
- Completes credentialing and re-credentialing applications for providers for Medicaid, Medicare, and private/commerical insurance payers. Identifies deficiencies and follows up to gather missing or incomplete data and status updates.
- Maintains existing contract and credentialing documents to ensure records and documents are complete, accurate and compliant with payers.
- Successfully increased reimbursement rates due to prior employment credentialing issues.
- Coordinates with providers and staff administrators.
- Submits clean claims for billing to ensure quick reimbursement. Works any denials in a timely manner. Contacts payers for further clarification or reconsideration.
- Verifies insurance eligibility and benefits for clients before services are rendered to reduce the amount of non payable claims.
Office Manager
East Arkansas Children's Clinic
Forrest City, AR
11.2002 - 09.2022
- Attained compliance with all stated funded programs such as PCMH, Meaningful Use, Episodes of Care.
- Achieved top 10% of providers in the state to maintain low cost threshold for state funded program PCMH and awarded financial bonus for 6 consecutive years.
- Completed credentialing and re-credentialing applications for new providers for private commercial insurance companies and Arkansas Medicaid. Maintained required documentation for payer contract and credentialing updates.
- Decreased amount owed on audit reviews by 75%.
- Trained and mentored staff members in company policies, daily task execution and best practices. Planned and led office meetings with administrative and clinical staff to discuss policy changes, patient concerns/issues, state funded program progress and compliance.
- Performed insurance verification, pre-certification and pre-authorization for services.
- Reviewed and submitted claims for insurance payers. Cooperated with Medicaid and private insurance payers to resolve billing issues.
- Monitored past due accounts and pursued collections on outstanding balances.
- Participated in workshops, seminars and training classes to gain stronger education in healthcare insurance updates and federal regulations.
- Resolved customer inquiries in a timely manner while maintaining positive relationships with clients.
- Delegated work to staff, setting priorities and goals.
Education
Bachelor Of Science - Business Administration
Arkansas State University
05.2022
Associate Of Science - Business
East Arkansas Community College
05.2020
Skills
- Significant healthcare credentialing experience
- CAQH experienced
- Medical Billing
- Bookkeeping
- Leadership/Management Skills
- Provider Relations
- Clearinghouse portal experienced
- Individual Insurance portal experienced
- Excellent customer service skills
- Superior skills in successful management of multiple tasks
- Excellent ability to effectively communicate both verbally and written with providers, staff, and external agencies
References
- William C. Patton, MD, (870) 261-2371, curtpatton@live.com
- Chelsea Kellow-Foister, DNP, APRN, (870) 400-7319, dr.kellowhedge@icloud.com
- Candace Shafer-Franks, MD, (870) 519-3153, csfranks@gmail.com
- Debra Frost, APRN, (870) 945-0737
- Lisa Drake, APRN, (870) 270-9513, lisadrakeapn@live.com
- Latrice Williams, APRN, (870) 494-5676
- Ann Murphy, MD, (205) 412-8268, anneliz122@yahoo.com
Timeline
Billing/Credentialing Specialist
Changes Behavioral Health
09.2022 - Current
Office Manager
East Arkansas Children's Clinic
11.2002 - 09.2022
Bachelor Of Science - Business Administration
Arkansas State University
Associate Of Science - Business
East Arkansas Community College
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