Summary
Overview
Work History
Education
Skills
Tel
Timeline
Generic

Angela Walker

Hampton,VA

Summary

Practice management professional with copious healthcare experience medical office management experience. (e.g., accounts payable, accounts receivable, billing, insurance processing, credentialing, physician and employee scheduling, employment human resources, purchasing, and marketing). Strong billing experience in charges, coding, insurance companies, accounts receivables, and in-house collections. Extensive knowledge in practice management. Excellent organizational skills and experience. Extensive experience with software, ICD-9, CPT, HCPCS coding, and insurance filing. Self-motivated, detail-oriented, eager to teach, learn and empower others Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success. Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance. Dedicated professional with a history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Multi-tasking Manager well-known for creating positive workplace culture and high-performing teams. Demonstrated expertise, including competitive offerings, pricing and market positioning. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level [Job Title] position. Ready to help team achieve company goals.

Overview

41
41
years of professional experience

Work History

CREDENTIALING MANAGER/Provider Relations, Provider Enrollment, Executive Support

Tidewater Physicians Multispecialty Group
01.2011 - Current
  • Over 200 providers Coordinates, oversees, and administer the credentialing and privileging process for all TPMG medical providers, in accordance with NCQA, and CMS accreditation standards, Federal and State laws
  • Leads, coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility
  • Conducts thorough research and primary source verification of all components of the application file
  • Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow-up
  • Utilizes the credentialing database, optimizing efficiency, and performs query, report and document generation; submits and retrieves National Practitioner Database reports under Health Care Quality Improvement Act
  • Coordinates, oversees, and administers the credentialing and privileging process for all TPMG medical providers, in accordance with accreditation standards
  • Reviews oversees and advises medical staff leadership and administration regarding credentialing/privileging appointments, reappointments, and expansion/reduction requests; assesses whether individuals with clinical privileges provide services within the scope of privileges
  • Ensures compliance with guidelines of Joint Commission and other internal or external reviewers as appropriate
  • Provides on-site consultations across TPMG regarding credentialing and privileging practices and services; prepares and conducts credentialing and privileging orientations and provides updates as appropriate on new policies and procedures
  • Functions as primary credentials and privileged contact for all internal and external inquiries; serves as a primary point of liaison between senior management and medical staff, and develops and maintains positive working relationships
  • Manages the credentialing and privileging database; monitors critical data for extensive analysis and report generation
  • Medical office management experience
  • (e.g., accounts payable, accounts receivable, billing, insurance processing, credentialing, physician and employee scheduling, employment human resources, purchasing and marketing)
  • Strong billing experience and contract negotiation skills with fee schedule adjustments with commercial payers, coding, insurances companies, accounts receivables, and in-house collections
  • Extensive knowledge in practice management software, ICD9, CPT, and HCPCS coding, and insurance filing
  • Manage the collection and payment processes.

CREDENTIALING COORDINATOR/INSURANCE BILLING manager/Self-employed

PPSEV, Newport News
01.1999 - 01.2010
  • Provided billing and coding for three medical facilities in the Hampton Roads area
  • Credentialed and set up providers and provider networks with medical practices
  • Day-to-day operations and insurance billing to include collections, charge posting, monthly reports, and marketing
  • Maintained billing and historical files and data, daily billing, and summary reporting to electronic billing services
  • Audited and maintained medical billing systems to meet required governmental standards
  • Extensive knowledge in practice management software, ICD-9, CPT, and HCPCS coding and insurance filing
  • Manage the collection and payment processes
  • Prepare complex reports for managed care organizations and insurance companies, ensuring full compliance with agency requirements and tight deadlines
  • Authored professional correspondence to customers and vendors
  • Conduct clinical sessions on how to increase revenue with proper coding
  • Communicate medical concepts to patients using non-technical language to facilitate understanding
  • Increased client revenue base by one-third resulting from insurance provider participation.

PRACTICE OFFICE MANAGER

Acute Care Associates/Mercury West Medical Center/Riverside Medical Center (acquired in 1992)
01.1983 - 01.1999
  • Managed four medical facilities in all aspects of multi-physician medical practice and office logistics from physician-employee-patient scheduling, network connectivity (e.g., satellite office, laboratory), billing, insurance, physician contracting with insurance companies-independent physician associations-hospitals, purchasing, marketing, payroll, reconciling practice financials for accountants and financial advisors
  • Acted as a liaison between the physician, employee, and patient in clinical and business settings
  • Responsible for renewing and maintaining records for physicians is federal and state licensures
  • Managed Daily Close to oversee patient demographics, charges, insurance, and patient payments
  • Proficient in QuickBooks, Excel, Word, PowerPoint, pdf file conversion, CPT, and ICD-9 insurance billing
  • Accountable for all aspects of physician, hospital, and provider recruitment and contracting as well as ad/hoc network contracting
  • Successfully negotiated payer network contracts with commercial payers
  • Ensured contracts and conditions were negotiated in the company's best interest to mitigate business risk and maximize financial objectives.

Education

Master of Arts - Business Administration And Management

Liberty University
Lynchburg, VA
01.2014

Master of Arts, Human Services -

Liberty University
01.2011

Bachelor of Science, Criminal Justice -

Liberty University
01.2010

Bachelor of Pre-Law -

Christopher Newport University
01.2001

Skills

  • Time Management
  • Contract Negotiation
  • Problem Solving
  • Software Proficiency
  • Performance Evaluation
  • Interpersonal Skills
  • Adaptability and Flexibility
  • Quality Assurance
  • Analytical Thinking
  • Policy Development
  • Application Processing
  • Team Leadership
  • Organizational Skills
  • Provider Enrollment
  • License Monitoring
  • Credential Verification
  • Staff Management
  • Task Delegation
  • Administration and Reporting
  • Onboarding and Orientation

Tel

757.732.3916

Timeline

CREDENTIALING MANAGER/Provider Relations, Provider Enrollment, Executive Support

Tidewater Physicians Multispecialty Group
01.2011 - Current

CREDENTIALING COORDINATOR/INSURANCE BILLING manager/Self-employed

PPSEV, Newport News
01.1999 - 01.2010

PRACTICE OFFICE MANAGER

Acute Care Associates/Mercury West Medical Center/Riverside Medical Center (acquired in 1992)
01.1983 - 01.1999

Master of Arts - Business Administration And Management

Liberty University

Master of Arts, Human Services -

Liberty University

Bachelor of Science, Criminal Justice -

Liberty University

Bachelor of Pre-Law -

Christopher Newport University
Angela Walker