Anthony Wiggins
Wesley Chapel,FL
Summary
U.S. Army veteran with extensive experience in credentialing and program management. Recognized for effectively maintaining data integrity and reducing hiring timelines while supervising and training teams. Strong organizational skills and ability to thrive under pressure.
Overview
30
30
years of professional experience
Work History
CREDENTIALING SPECIALIST
JAMES A. HALEY VA
06.2021 - Current
- Processed credentials for LIP and Non-LIP providers by verifying identification, licenses, and employment history.
- Monitored expiring state licenses, certifications, and registrations for over 2500 non-LIP providers.
- Ensured credentialing data integrity through daily entry in VetPro and other systems.
- Communicated adverse findings with supervisors, HR, and clinical services.
- Trained new staff on credentialing processes and supported colleagues with ongoing guidance.
- Coordinated projects within the credentialing office to streamline processes and enhance workflow.
- Provided customer support for VetPro inquiries from incoming and current staff.
VOUCHER EXAMINER
VHA OCC, POM - DELIVERY OPERATIONS
LARGO, FL
02.2016 - 06.2021
- Fielded and resolved hundreds of veterans and vendor phone calls on customer service line regarding hospital denials, payment processes, and eligibility issues; processed Emergency Room notifications and provided timely call-backs to vendors after hours.
- Educated vendors in proper billing and payment methods. Taught vendors to upload, and update payee information with the U.S. Treasury. Accessed the Financial Management Service, (FMS) to troubleshoot and correct discrepancies with payments.
- Created, notified and monitored an Excel database of all Bill of Collections (BOC) when vendor was paid incorrectly or overpaid. Recouped over $250,000 dollars in collection payments to VA.
- Managed monthly Excel spreadsheet of 50+ vendors with overdue BOCs; contacted each vendor monthly to collect outstanding debts, facilitating timely payment recovery.
- Proficiently uses the following applications to process medical claims: VA Medical Claims Processing System (eCAMS), Provider Profile Management System (PPMS), ECATS, FBCS, Joint Longitudinal Viewer (JLV), FPPS, Citrix, VISTA, CPRS, Financial Management System (FMS), HealthShare Referral Manager (HSRM), Attachment Retrieval System (ARS).
- Finalized all payment batches daily in FBCS; located all pending rejects for reinitiating and processing.
- Resolves hundreds of error-codes for claims to be correctly processed through eCAMS.
- Determines veterans Emergency Administrative Eligibility Criteria based on criteria met for correct payment method.
- Prepared authorizations for Non-Service-Connected Eligibility (Mill Bills/1725) and Emergency Unauthorized Eligibility (1728), ensuring compliance with VA payment processes.
PROGRAM SPECIALIST, CREDENTIALING
VA MED CTR, WEST PALM BEACH
WEST PALM BEACH
11.2012 - 07.2015
- Collaborated with service chiefs to streamline credentialing processes for new employees and enhance verification standards for current staff.
- Reduced medical staff hiring and privileging timeline by 10 calendar days through reorganization and agency coordination.
- Maintained Excel database to track completion of focused practice provider evaluations and ongoing evaluations.
- Reviewed and edited twelve medical center memorandums and SOPs biannually, facilitating timely approval from directors.
- Assisted human resources in hiring processes by reporting discrepancies to VA chief of staff.
- Managed annual purchase card budget of $50,000, ensuring prompt credentialing through primary source verifications.
PROGRAM ADMIN ASST, INFECTION CONTROL
VHA,WEST PALM BEACH
WEST PALM BEACH, FL
01.2010 - 10.2012
- Received Best Practice from Joint Commission for Hand Hygiene, "Secret Shopper" Campaign.
- Project Leader of $50,000 grant to purchase and install 36 Dyson Hand Dryers in select high traffic restrooms throughout the medical center.
- Analyzed and monitored the compliance program for hand hygiene and contact isolation practices for all VA West Palm Beach and Outpatient Clinics by collecting 25-30 observation sheets bi-weekly. Designed PowerPoint presentation on Hand Hygiene effectiveness in the WPB Medical Center.
- Co-authored and distributed 1500 monthly Infection Prevention newsletters to West Palm Beach VA employees, enhancing awareness of infection control practices.
- Oversaw purchase card with $120,000 annual budget for acquiring equipment, learning aides, and instructional tools for Infection Control/MRSA program.
- Service PIV Manager/Sponsor. Entered new employees into the PIV Portal and processed PIV card reissuances staff.
- Organized and assisted with New Employee Orientations for Infection Control.
PROGRAM SUPPORT CLERK
VA MEDICAL CENTER, WPB
WPB
01.2007 - 01.2010
- Credentialed dependent providers, which entailed verifying employment history, licenses/certifications, and education.
- Developed a streamlined method for credentialing dependent staff by coordinating with HR to provide VetPro access on the first day of qualification.
- Monitored expiring status of all state licenses, board certifications, and BLS/ACLS certifications for over 300 Dependent Providers in the Medical Center.
- Partnered with Human Resources (HR) to implement paperless project, auditing over 500 employee folders and thousands of documents for scanning.
- Developed the Dependent Provider Priv+ Database.
ACCOUNTS RECEIVABLE COORDINATOR
DRIFTWOOD HOSPITALITY AND MANAGEMENT
PALM BEACH GARDENS, FL
01.2005 - 01.2007
- Retrieved over $15 million annually in payments from discount travel companies through web applications.
- Streamlined financial processes using accounting software, including MAS 200, Opera, and Expedia Merchant Point.
HUMAN RESOURCES ASSISTANT, MOS 42A
U.S. ARMY
01.1996 - 01.2005
- Managed human resources actions for over 700 uniformed personnel across three European Theatre countries.
- Specialized in NCOER and OER evaluations, ensuring accurate tracking of promotions and selections for 250 officers and 700 enlisted personnel.
- Received two Army Accommodation Medals, two Army Achievement Medals, and multiple Certificates of Achievement.
Education
BACHELOR OF SCIENCE - BUSINESS MANAGEMENT
UNIVERSITY OF PHOENIX
08-2010
HUMAN RESOURCES TRAINING - ADVANCED INDIVIDUAL TRAINING (AIT)
US ARMY
Fort Jackson, SC05-1996
Skills
- Credentialing
- Credentialing documentation
- VetPro management
- Compliance management
- Claims processing
- Verification techniques
- Data analysis
- Process improvement
- Customer management
- Problem solving
- Team collaboration
- Effective communication
References
Available upon request
Volunteer Community Service
- Team Administrator and Head Coach Basketball Coach, RADD Sports, Wesley Chapel, FL, 01/01/22, Current
- Team Administrator and Head Coach, Bay Area Elite, 501(c)(3) Basketball, Tampa, FL, 01/01/17, 12/31/22
- Head Coach, Upward Stars 3-7th Grade AAU/ Travel Basketball Team, Gainesville, FL, 01/01/07, 12/31/17
Timeline
CREDENTIALING SPECIALIST
JAMES A. HALEY VA
06.2021 - Current
VOUCHER EXAMINER
VHA OCC, POM - DELIVERY OPERATIONS
02.2016 - 06.2021
PROGRAM SPECIALIST, CREDENTIALING
VA MED CTR, WEST PALM BEACH
11.2012 - 07.2015
PROGRAM ADMIN ASST, INFECTION CONTROL
VHA,WEST PALM BEACH
01.2010 - 10.2012
PROGRAM SUPPORT CLERK
VA MEDICAL CENTER, WPB
01.2007 - 01.2010
ACCOUNTS RECEIVABLE COORDINATOR
DRIFTWOOD HOSPITALITY AND MANAGEMENT
01.2005 - 01.2007
HUMAN RESOURCES ASSISTANT, MOS 42A
U.S. ARMY
01.1996 - 01.2005
BACHELOR OF SCIENCE - BUSINESS MANAGEMENT
UNIVERSITY OF PHOENIX
HUMAN RESOURCES TRAINING - ADVANCED INDIVIDUAL TRAINING (AIT)
US ARMY