Results-driven professional with proven success in enrollment management, compliance verification, and provider credentialing. Expertise in application processing and data tracking, ensuring adherence to healthcare regulations.
Overview
12
12
years of professional experience
Work History
Payer Enrollment Specialist
Fast Pace Mississippi
Nashville, TN
04.2025 - Current
Tracked and managed provider data and progress using enrollment management software, ensuring timely updates and accuracy.
Reviewed applications for accuracy before submitting to appropriate entities for processing.
Collaborated with insurance carriers and brokers to ensure accurate and timely enrollment of providers.
Advised hospital CEO and designated contacts on necessary paperwork for initiating application processes for new physicians, facilitating smoother onboarding.
Completed required form and applications for changes or updates in billing systems including EFT and or notification of Athena.
Performed re-credentialing for providers and completed applications for new acquisitions, ensuring compliance and seamless integration.
Credentialing Specialist
Tennessee Oncology
Nashville, TN
05.2020 - 04.2025
Coordinated provider credentialing process for multiple oncology specialists, ensuring timely and accurate completion.
Ensured compliance with industry regulations and standards.
Partnered with insurance companies to verify and update provider data, enhancing data integrity.
Assisted in onboarding new staff through credentialing support.
Maintained database of credentials using specialized software systems.
Evaluated and processed credentialing applications for accuracy, completeness, and adherence to accreditation standards.
Processed re-credentialing applications for existing providers according to contractual requirements.
Provider Enrollment Specialist
Quorum Health
Brentwood, Tennessee
04.2018 - 05.2020
Managed provider enrollment processes for multiple healthcare facilities within the organization.
Reviewed and verified provider applications to ensure compliance with regulations.
Collaborated with internal teams to resolve enrollment issues and improve workflows.
Educated providers on enrollment requirements and documentation needed for approval.
Maintained accurate records in the enrollment database and tracking systems.
Responded to requests for information about enrollment process.
Credentialing Coordinator
BreatheAmerica
Franklin, Tennessee
08.2014 - 04.2018
Managed provider credentialing processes for healthcare professionals and facilities.
Ensured timely completion of applications and re-credentialing tasks to support uninterrupted provider services.
Coordinated communications between providers and regulatory agencies to maintain compliance with credentialing standards.
Maintained accurate databases for credentialing records and status updates.
Collaborated with cross-functional teams to streamline credentialing workflows, enhancing overall process efficiency.
Conducted training sessions for staff on credentialing policies and procedures.