Amy Mooney
Webster,NY
Summary
I currently serve as Senior Credentialing & Provider Enrollment Specialist with a rich background across diverse healthcare settings, encompassing both hospital and group practices. My expertise extends across multiple specialties and markets, demonstrated through my proficiency in various areas such as provider onboarding, payer enrollment, provider credentialing, medical billing, insurance verification, financial counseling, and the development of payment plans for uninsured individuals. I hold a comprehensive skill set, with extensive knowledge that enables me to provide exceptional value to clients while playing a pivotal role in optimizing group operations. My efforts focus on streamlining operations, resulting in reduced accounts receivable wait times, and minimized claim denials. Alongside my practical experience, I hold a PESC certification further validating my expertise in the field.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Sr. Credentialing & Enrollment Specialist
Payradvisors
01.2024 - Current
- Provider onboarding, credentialing, and payer enrollment.
- Facility credentialing and recredentialing
- Collaborative agreements.
- Resolving A/R issues that may pertain to credentialing.
- Maintaining CAQH profiles.
- Delegated Credentialing and Rosters
- Projects as assomged
Credentialing & Enrollment Specialist (Remote)
Sound Physicians
04.2023 - 10.2023
- Credentialig of new providers
- Initial Provider insurance enrollemnt in the Ohio, Texas, and California Markets
- Insurance recredentialing and revalidations for group and individual providers
- Assist in other markters when needed
- Projects as assigned
Credentialing Specialist (Remote)
OneOncology – Nashville, TN
12.2021 - 04.2023
- Credentialing of Physicians for Oncology Practices in New jersey & Pennsylvania
- Hospital Credentialing & Insurance Enrollment for Group and Individuals
- Special Projects as assigned
Credentialing Specialist & Enrollment Specialist
RadNet - Pittsford, NY
03.2021 - 11.2021
- Credentialing of Maryland, California and Florida practices and providers, training of staff, special projects as assigned
- Credentialing of V-Rad provider, reviewing of locum and MQSA provider packets.
Property Tax Research Associate -Contract Only
CoreLogic - Rochester, NY
07.2020 - 03.2021
- Research of tax data and process tax payments
- Processes and researches a high volume of issues, where issues are typically more complex that requires moderate knowledge of customer and company requirements
- Makes outbound phone calls to taxing authorities to procure data
- May perform a variety of clerical functions within Tax Services to ensure timely procurement and accurate payment of taxes
- Conducts research of tax data.
Provider Enrollment Specialist
Rochester Regional Health System
12.2016 - 05.2020
- Enrollment of Providers to Medicaid/Excellus/MVP, Medicaid revalidations for individual providers and groups
- Recertification of Medicaid E Tins and management of the Claims Logic report
- Enrollment of Behavioral Health and Dental providers for all payers
- Researching enrollment issues and solving enrollment problems for Medicaid and Excellus
- Assisting in training of new employees to the team, and assisting the team lead, manager, and director with additional assignments as needed.
Accounts Receivable Coordinator
ARC of Monroe
09.2014 - 12.2016
- Billing of all Article 16 Clinic patients /clinician credentialing/collection of article 16 accounts/follow up with insurances to ensure prompt claim payment/projects as assigned.
Customer Care Specialist 2
E-health Technologies
01.2012 - 08.2014
- CSS 2+ - Retrieval of medical records, pathology materials, and radiology images for patients and hospitals in need of cancer and transplant care for the Mid-West and Southwest Regions of the country
- Obtain authorizations from patients to retrieve medical information and materials if needed
- Assist the Regional team leader and CSS3 with team member problems and questions
- Work with our customers to provide accurate and timely turnaround time of all records and materials to ensure patient care
- Special projects as assigned.
Credentialing Coordinator
Radnet Management Inc
10.2009 - 12.2011
- Credentialing of all new physicians and re-credentialing of all current physicians with all insurances
- Maintaining all physician documents and licenses to ensure prompt insurance payments and decrease receivable
- Projects as assigned.
Education
Associates Degree in Business Management -
Bryant & Stratton Business School
01.1994
Skills
- Medical billing
- Insurance verification
- Payer enrollment
- Physician credentialing
- Financial counseling
- Medical record/imaging/pathology retrieval
- HIPAA regulations
- Billing and auditing of patient accounts and insurances
- Customer service
- Interpersonal skills
- Supervision
- Accounts receivable
- Accounts payable
- MDStaff
- Modio
- PECOS
- AVAILITY
- ONBOARD PRO
- NAVINET
- MUPLIPLE MEDICAD PORTALS
- EXCEL
- SMART SHEET
- TEAMS
- WORD
- POWER POINT
- ADOBE
- CAQH
- APOGEE
- CARE CONNECT
- Claims Logic (TriZetto)
- EPIC
- EGNYTE
- NPDB
- NPPES
- DOCUSIGN
- Customer service expertise
- Telephone and email skills
- Provider Relations
- Record maintenance
- Workflow Optimization
- Customer service background
- Strong Organization
- Time management proficiency
- Documentation Management
Certification
- Provider Enrollment Specialist Certified
References
References available upon request.
Timeline
Sr. Credentialing & Enrollment Specialist
Payradvisors
01.2024 - Current
Credentialing & Enrollment Specialist (Remote)
Sound Physicians
04.2023 - 10.2023
Credentialing Specialist (Remote)
OneOncology – Nashville, TN
12.2021 - 04.2023
Credentialing Specialist & Enrollment Specialist
RadNet - Pittsford, NY
03.2021 - 11.2021
Property Tax Research Associate -Contract Only
CoreLogic - Rochester, NY
07.2020 - 03.2021
Provider Enrollment Specialist
Rochester Regional Health System
12.2016 - 05.2020
Accounts Receivable Coordinator
ARC of Monroe
09.2014 - 12.2016
Customer Care Specialist 2
E-health Technologies
01.2012 - 08.2014
Credentialing Coordinator
Radnet Management Inc
10.2009 - 12.2011
Associates Degree in Business Management -
Bryant & Stratton Business School