Arlena Griggs
Angleton
Summary
Detail-oriented Provider Enrollment Specialist II with extensive experience in multi-state, multi-payer enrollment, billing coordination, and compliance within fast-paced healthcare environments. Proven ability to manage high-volume enrollments, resolve complex payer issues, and ensure timely provider credentialing to maximize revenue. Strong expertise in Medicare, Medicaid, and commercial payer processes, with advanced proficiency in industry systems and regulatory compliance.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Provider Enrollment Specialist II
Envision Physician Services (Envision Healthcare)
07.2022 - Current
- Manage high-volume provider enrollments across multiple states, payers, and contract sites, ensuring accuracy and timely submission.
- Prepare, review, and submit complex enrollment applications, verifying completeness and compliance with payer-specific requirements.
- Serve as a subject matter expert, providing guidance, training, and support to Enrollment Coordinators.
- Collaborate with clinicians, payers, and internal teams to expedite enrollments and secure billing approvals.
- Maintain and track application status using internal systems and Excel reporting tools for performance accuracy.
- Partner with billing teams and third-party vendors to resolve enrollment-related claim rejections and system issues.
- Monitor and reduce Held A/R, ensuring timely enrollment submissions to prevent revenue loss.
- Build strong payer relationships to facilitate faster processing and issue resolution.
- Ensure compliance with HIPAA, HITECH, and payer regulations throughout all processes.
- Handle complex enrollment scenarios requiring critical thinking, prioritization, and independent decision-making.
Hospitalist Coordinator / ER & Urgent Care Billing Coordinator
Emcare/Envision Physician Services
11.2010 - 07.2022
- Reviewed and validated physician documentation to ensure compliance and billing accuracy.
- Performed daily data entry and charge capture for physician services.
- Generated and monitored reports to identify missing or unbilled charts, ensuring timely submission.
- Coordinated with physicians and leadership to address documentation and compliance gaps.
- Assisted patients, hospital staff, and billing teams with inquiries, reconciliations, and issue resolutions.
- Supported revenue cycle operations by improving workflow efficiency and reducing billing delays.
- Managed physician scheduling communication and administrative coordination.
Education
Business Communication
Brazosport Jr College
01-1986
Skills
- Provider Enrollment & Credentialing
- Pre-Enrollment & Application Processing
- Multi-State / Multi-Payer Enrollment
- Billing & Revenue Cycle Support
- Compliance: HIPAA & HITECH
- Claims Resolution & Held A/R Management
- Process Improvement & Training Support
- Systems & Platforms: Kronos, Oracle Cloud (EnWorks) PECOS, EmBillz, CAQH, DocuSign, Availity
- Payers: Medicare, Medicaid, Blue Cross Blue Shield (BCBS) Tricare
- Provider Passport
Certification
- Certified Provider Credentialing Specialist (CPCS) – if applicable
- Any compliance or healthcare certifications
Timeline
Provider Enrollment Specialist II
Envision Physician Services (Envision Healthcare)
07.2022 - Current
Hospitalist Coordinator / ER & Urgent Care Billing Coordinator
Emcare/Envision Physician Services
11.2010 - 07.2022
Business Communication
Brazosport Jr College
ADDITIONAL EXPERTISE
- Fingerprinting & Provider Screening Processes
- Enrollment Audits & Quality Assurance
- Contract Enrollment (large-scale: 10+ contracts / 40+ providers)
- Strong Written & Verbal Communication
- Relationship Management with Payers & Providers