Amanda Birky
Wanatah,IN
Summary
Experienced administrative professional with 30+ years in provider credentialing services. Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans.
Overview
16
16
years of professional experience
Work History
Credentialing / Contracting Analyst
Geminus Corporation
Merrillville, IN
07.2010 - Current
- Received and evaluated applications to look for missing and inaccurate information.
- Conducted primary source verifications such as background checks and board certifications.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Determined licensing eligibility by examining test results and comparing against established structures.
- Maintained composure in stressful situations, confrontations, interviews and records searches.
- Assessed fees related to registration of property-related documents.
- Took notes on field examinations and specific case details, updated databases and produced reports outlining results of investigations.
- Entered into record-keeping systems appropriate data needed to create new records or update existing ones.
- Confirmed data and licensing information through investigations and notified violators of required changes to bring operations into compliance.
- Kept informed regarding pending industry changes, trends or best practices.
- Investigated locations to confirm license data, conducted background checked and assessed premises for compliance with licensing requirements.
Medical Staff Credentialing Coordinator
Porter Hospital
Valparaiso, IN
03.2007 - 11.2009
- Collected and analyzed information to monitor compliance outcomes and identify and address trends of non-compliant behavior.
- Planned, monitored and appraised employee work results by training managers to coach and discipline employees.
- Pre-screened resumes prior to sending to corporate hiring managers for consideration.
- Improved office efficiency by effectively managing internal communications and correspondence.
- Partnered with departmental managers to ascertain hiring needs and subsequently provide candidate recommendations.
- Coordinated implementation of people-related services, policies and programs through departmental staff.
- Advocated for staff members, helping to identify and resolve conflicts.
- Planned and launched large-scale events that boosted employee participation by Number%.
- Developed and implemented performance improvement strategies and plans to promote continuous improvement.
- Offered friendly and efficient service to customers, handled challenging situations with ease.
- Worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.
- Monitored company inventory to keep stock levels and databases updated.
Medical Staff Coordinator
Pinnacle Hospital
Crown Point, IN
06.2005 - 04.2007
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Spearheaded and implemented new projects to expand scope of engagement.
- Defined testing protocols, quality assurance initiatives and clinic policies and procedures.
- Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
Education
Didn't Graduate - Nursing
Purdue University - North Central
Westville, INChesterton Senior High School
Chesterton, IN06.1986
Skills
- Facility support
- Accreditation information management
- Insurance credentialing processes
- Application coordination
- Microsoft Nextgen, Avatar expertise
- Provider enrollment
- Provider Relations
- Data verification
- Vulnerability examination
- JCAHO regulations
- Auditing experience
- Data presentation skills
- Word Excel, use
Timeline
Credentialing / Contracting Analyst
Geminus Corporation
07.2010 - Current
Medical Staff Credentialing Coordinator
Porter Hospital
03.2007 - 11.2009
Medical Staff Coordinator
Pinnacle Hospital
06.2005 - 04.2007
Didn't Graduate - Nursing
Purdue University - North Central
Chesterton Senior High School
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