Castina Hearn, MHA

• Managed necessary reports, such as, change of information, revalidation, and renewal submissions for Alaska, Alabama, New Mexico, Montana, and Oklahoma regions.
• Updated certificate of need (CON), clinical laboratory improvement amendments (CLIA), state license, Medicare 855A, Medicaid, and national provider identifier (NPI) with updated information for each provider.
• Maintain communication with state and federal authorities; ensure timely processing of licensure and enrollment filings.
• Organized and completed required documentation for clinical personnel filings to various state and federal agencies; coordinate with field personnel, as necessary.

• Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.

Temporary FEMA assignment, credentialing health professionals around the U.S. within 48 hours so they can provide vaccines.

• Tracked expiration dates on documents and communicated with appropriate staff to prevent gaps in service delivery.
• Maintained accurate files, records and credentialing documents in well-maintained databases using AMIE.
• Reviewed healthcare providers’ submitted requirements such as, licensure, certifications, screens and other critical documents using AMIE to determine requirements needed for specific assignment.

Contract Position

• Obtained authorizations from multiple insurance carriers for various levels
• Work closely with Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing.
• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases.
• Communicated with referral providers about new referrals and verified receipt of necessary information before arrivals.
• Supervised and maintained all utilization review documentation through Kareo.

• Conducted functional behavior assessments, functional analysis, preference assessments and assessments of basic learning and language skills to identify target behaviors and purpose of behaviors.
• Observed, monitored and recorded problem behaviors through accurate behavior-consequence data collection, graphs and anecdotal notes.
• Used Central-Reach to document patient information, progress notes and treatment plans.
• Developed goal-oriented psychoeducational and activity therapy groups to improve clients' level of functioning.

• Assisted Social Workers with medical records reviews to facilitate improved performance and quality assurance.
• Conducted outreach to local referral sources to build strong partnerships for supportive services.
• Planned and organized special events, solicited corporate sponsorships and set up matching gift donations to reach financial targets.
• Assisted families in developing and maintaining support network by identifying and utilizing community resources and services.