Carrie Klee
Summary
Results-driven Provider Enrollment Representative skilled in navigating complex regulatory environments and enhancing client satisfaction. Proven ability to streamline enrollment processes and mentor colleagues, contributing to team performance and compliance. Focused on delivering measurable outcomes through effective communication and thorough reporting.
Overview
18
18
years of professional experience
Work History
Provider Enrollment Representative
LogixHealh, Inc
Bedford, MA
11.2024 - Current
- Contact between multiple payers, providers and clients.
- Communicate and advise designated clients and provider as to necessary paperwork required to begin the application process for new providers as well as revalidation.
- Prepare and review report for payer statuses and distribute to appropriate contact to provide identification numbers, effective and revalidation dates as needed.
- Track all enrollment in the company’s enrollment system (Symplr) and billing system (Allscripts) to ensure accurate billing and determine any payor gaps In revenue.
- Use PECOS, CAQH, NPPES as needed to maintain up to date record.
- Assist with training fellow colleagues on payors I have knowledge of and any other duties to assist Management team.
Provider Enrollment Specialists
Ventra Health (formerly Duvasawko ED Billing and Management)
Ormond Beach, FL
04.2011 - 08.2024
- Work with clients to enroll providers in Medicare, Medicaid, (for Florida Blue insurance.
- Review and submit provider as well as group renewals for both Medicare (FL,IL,LA,GA, IA) and Medicaid LA, FL) as well as Florida BlueCross Blue Shield Insurance.
- Ensure provider medical license, DEA, and NPI registry are accurate and up to date.
- Initiate ACHA fingerprinting and background screening renewals (for FL).
Senior Billing Specialist
Ventra Health (formerly Duvasawko ED Billing and Management)
Ormond Beach, FL
- Download and batch EFT payments received for payment posting, batch live mail received for payment posting, and scan bank deposits for the client team.
- Balance daily posting for clients and assist billing representatives to locate errors when out of balance.
- Assign daily payment posting to billing representatives.
- Download Auth.net credit card payment notifications, download insurance EOBs to 835 files if applicable, or place in file for posting.
- Assign daily holds to be worked, zero remittance notices received by ERA (Electronic Remittance Advices).
- Train and guide all billing representatives and new hires to the client team.
- Work claims hold and denials as well as submit appeals if needed or determine if adjustments are needed.
- Answer calls regarding billing questions and credit card payments as well as assist with escalated calls.
CRR Representative
Ventra Health (formerly Duvasawko ED Billing and Management)
Ormond Beach, FL
- Verify auto and worker's compensation claims for accurate billing.
- Followed up on outstanding auto and worker compensation claims.
- Submit appeals for worker's compensation denials.
Insurance Follow Up
Orthopedic Clinic of Daytona Beach
Daytona Beach, FL
02.2008 - 04.2011
- Follow up on personal, auto, and worker's compensation insurance claims to ensure prompt payment.
- Initiate appeals when claims are underpaid per contract, bundling etc.
Education
High School -
Mainland High School
Daytona Beach, FL06-1991
Skills
- Provider enrollment
- Billing reconciliation
- Claims processing
- Regulatory compliance
- Data tracking
- Client relationship management
- Report preparation
- Training and mentoring
- Problem resolution
- Effective communication
- Attention to detail
- Team collaboration
- Time management
- Analytical thinking
- Re-credentialing request follow up
- Special projects
- HIPAA compliance awareness
- Data entry proficiency
- Reporting and file reviews
- Continuous learning attitude
- Medical terminology
Timeline
Provider Enrollment Representative
LogixHealh, Inc
11.2024 - Current
Provider Enrollment Specialists
Ventra Health (formerly Duvasawko ED Billing and Management)
04.2011 - 08.2024
Insurance Follow Up
Orthopedic Clinic of Daytona Beach
02.2008 - 04.2011
Senior Billing Specialist
Ventra Health (formerly Duvasawko ED Billing and Management)
CRR Representative
Ventra Health (formerly Duvasawko ED Billing and Management)
High School -
Mainland High School