Chyna Smith
Denton,TX
Summary
Healthcare operations and provider enrollment professional with a proven track record of navigating complex regulatory requirements, ensuring compliance, and streamlining processes for optimal efficiency. Exceptional organizational skills, problem-solving abilities, and effective communication. Strong focus on team collaboration and achieving results through operational oversight, process improvement, and team leadership. Skilled in customer interactions, service solutions, conflict resolution, and problem-solving. Reliable and proactive team collaborator, adaptable to changing needs, consistently focused on achieving results through efficient and empathetic service. Experienced in managing provider enrollment processes, ensuring timely and accurate credentialing. Utilizes strong communication and organizational skills to enhance workflow efficiency while maintaining knowledge of compliance regulations and documentation management for seamless operations.
Overview
6
6
years of professional experience
Work History
Credentialing /Provider Enrollment Specialist
ComplexCare Solutions ( Remote )
10.2024 - Current
- Facilitate seamless transitions between different stages of the enrollment process by maintaining open lines of communication among various departments involved in provider services operations.
- Troubleshoot technical issues related to the online enrollment system, providing prompt resolutions for providers and internal stakeholders alike.
- Streamline provider enrollment processes by implementing efficient data management systems.
- Assist providers with navigating online portal systems, enhancing user experience and expediting application submissions.
- Serve as the primary contact for Provider Enrollment claim denials with payors, SCP Medical Collections, Revenue Integrity, Systems, and Managed Care departments.
- Enter, update, and maintain NPI and other applicable provider numbers.
- Establish and maintain data entry in CAQH.
- Analyze enrollment data and trends to identify opportunities for process improvement and efficiency enhancement.
- Enhance team productivity by conducting regular training sessions on industry standards and best practices.
- Monitor credentials and contact practitioners as expiration dates approach.
- Reduce errors in provider applications through meticulous attention to detail and thorough review procedures.
- Schedule and manage remote appointments, coordinate patient check-in and checkout, and verify insurance information.
- Use EMR software to enter provider effective dates into enrollment database.
- Streamlined provider enrollment processes by implementing efficient data management systems.
- Facilitated seamless transitions between different stages of the enrollment process by maintaining open lines of communication among various departments involved in provider services operations.
- Assisted providers with navigating online portal systems, enhancing user experience and expediting application submissions.
- Contributed towards policy updates by sharing insights from hands-on experience dealing with unique or challenging enrollment scenarios.
- Consistently met or exceeded departmental performance targets through diligent management of individual workload and effective collaboration with team members.
Data Entry/Provider Enrollment Specialist
Medical City Lewisville (Remote)
08.2023 - 10.2024
- Handled 50+ calls daily
- Dealt and Assisted patients and their families through remote communication channels, such as phone and online chat, ensuring they received accurate information and guidance
- Provided exceptional customer service by addressing patient inquiries, concerns, and requests promptly and professionally.
- Offered remote billing assistance, explained payment options, and assisted with insurance-related questions, ensuring a smooth patient experience.
- Completed enrollment of all providers timely and accurately. Consistently maintained effective processes for monitoring provider enrollment status for all payer funding sources.
- Maintained production requirements determined by Manager.
- Acted as a remote liaison between patients and medical staff, facilitating clear and effective communication
- Collaborated with hospital personnel and resolved patient concerns and issues while working remotely
- Maintained and updated patient records with meticulous attention to detail, ensuring data accuracy and confidentiality
- Collaborated with the Enrollment team to ensure changes are made when provider enrollment errors occur.
- Collaborated with cross-functional teams for timely resolution of enrollment issues, improving overall customer satisfaction.
- Streamlined provider enrollment processes by implementing efficient data management systems.
- Facilitated seamless transitions between different stages of the enrollment process by maintaining open lines of communication among various departments involved in provider services operations.
Customer Service Representative Manager
CornerStone Staffing (Norwex)
04.2022 - 07.2023
- Handled 50+ calls daily
- Received inbound calls from clients for real estate business or complaints and made outbound calls to service providers for issue resolution
- Managed escalated cases effectively to achieve timely resolutions while maintaining professionalism under pressure.
- Reassigned work orders to appropriate personnel
- Placed outbound calls to clients to inquire about problems encountered and sent out appropriate technicians for service provision
- Opened and maintained clients’ accounts by recording account information
- Resolved product or service problems by clarifying the customer's complaint; determined the cause of the problem; selected and explained the best solution to solve the problem; expedited correction or adjustment; followed up to ensure resolution
- Prepared product or service reports by collecting and analyzing client information
- Contributed to team effort by accomplishing related results as needed
- Kept records of clients’ interactions, processed clients’ accounts and filed documents
- Followed communication procedures, guidelines, and policies.
- Handled customer inquiries and suggestions courteously and professionally.
- Took ownership of customer issues and followed problems through to resolution.
- Improved customer satisfaction by addressing and resolving complex issues promptly and professionally.
- Established strong relationships with clients, promoting trust and loyalty in our brand.
Operations Supervisor
AMS Fulfillment
07.2020 - 03.2022
- Managed daily operations for optimal performance, ensuring smooth workflows and timely completion of tasks.
- Maintained open lines of communication with upper management to provide regular updates on operational progress and challenges faced by the team.
- Conducted regular performance evaluations for direct reports, identifying areas for improvement and setting development goals accordingly.
- Reduced employee turnover by fostering a positive work environment and addressing employee concerns promptly.
- Ensured compliance with company policies, industry regulations, safety standards, and local laws during daily operations.
- Improved operational efficiency by streamlining processes and implementing time-saving strategies.
- Collaborated with cross-functional teams to develop innovative solutions for improving overall business performance.
- Contributed to long-term strategic planning discussions within the leadership team to help shape future direction for the business unit.
- Optimized resource allocation through careful planning and monitoring of inventory levels, staffing needs, and equipment maintenance schedules.
- Implemented predictive maintenance schedule for equipment, drastically reducing unexpected downtime.
- Initiated cost-saving initiative by renegotiating supply chain contracts, resulting in improved margins.
- Coordinated with IT department to deploy new inventory management system, leading to smoother operational flow.
- Achieved significant cost savings with thorough vendor contract negotiations.
- Reduced waste and optimized resource allocation with revamped inventory control system.
- Led cross-functional teams to improve project execution, enhancing overall operational efficiency.
Customer Service Representative
Mechanix Wear
05.2019 - 06.2020
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Collaborated with team members to develop best practices for consistent customer service delivery.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
- Improved resolution time with effective problem-solving for customer complaints.
- Coordinated with logistics department to expedite shipping for urgent customer orders.
- Participated in cross-functional teams to discuss ways to improve overall customer satisfaction across company.
- Developed feedback system for customers to share their service experience, leading to actionable improvements.
- Conducted training sessions for new hires, ensuring consistent level of service across team.
- Trained new Customer Service Representatives on company policies, procedures, and best practices.
- Updated company's FAQ section to include answers to common customer questions, reducing inquiry volume.
- Boosted team morale by consistently recognizing colleagues' contributions and achievements.
- Resolved escalated customer issues, restoring confidence in company's commitment to service excellence.
Education
High School Diploma -
Opportunities For Learning
Santa Clarita, CA05-2019
Skills
- Strong communication skills
- HIPAA compliance awareness
- Effective written and verbal communication
- Leadership qualities
- Relationship building
- Medical terminology
- Data entry proficiency
- Healthcare regulations
- Knowledgeable in Epic
- Salesforce
- Task delegation
- Strategic thinking
- Customer relations
- Proficiency in Excel
- Performance monitoring
- Negotiation
- Operations management
- Project management experience
Timeline
Credentialing /Provider Enrollment Specialist
ComplexCare Solutions ( Remote )
10.2024 - Current
Data Entry/Provider Enrollment Specialist
Medical City Lewisville (Remote)
08.2023 - 10.2024
Customer Service Representative Manager
CornerStone Staffing (Norwex)
04.2022 - 07.2023
Operations Supervisor
AMS Fulfillment
07.2020 - 03.2022
Customer Service Representative
Mechanix Wear
05.2019 - 06.2020
High School Diploma -
Opportunities For Learning
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