Crystal Black
Sioux Falls,SD
Summary
Dynamic Provider Enrollment Specialist with a proven track record at Sanford, adept at streamlining enrollment processes and enhancing compliance. Skilled in data management and relationship building, I leverage strong communication abilities to resolve provider inquiries efficiently. Committed to continuous learning and improving operational workflows in fast-paced environments.
Overview
12
12
years of professional experience
Work History
Provider Enrollment Specialist
Sanford
Sioux Falls, SD
01.2022 - Current
- Assisted in gathering and verifying provider documentation for enrollment processes.
- Supported the completion of applications for various provider types, ensuring compliance with regulations.
- Collaborated with internal teams to streamline data entry and maintain accurate records in enrollment systems.
- Conducted preliminary audits on provider files to identify discrepancies and facilitate corrections.
- Engaged in ongoing training sessions to enhance knowledge of enrollment policies and procedures.
- Responded to inquiries from providers regarding enrollment statuses and requirements promptly.
- Monitored updates in federal and state regulations impacting provider enrollment practices.
- Streamlined provider enrollment processes by implementing efficient data management systems.
- Assisted providers with navigating online portal systems, enhancing user experience and expediting application submissions.
Medical Biller
Accredo Specialty Pharmacy
Sioux Falls, SD
01.2020 - 01.2022
- Processed insurance claims efficiently, ensuring accurate coding and billing practices.
- Collaborated with healthcare providers to resolve discrepancies in patient billing statements.
- Reviewed and verified billing data for accuracy, minimizing errors in accounts receivable.
- Utilized electronic medical record (EMR) systems to streamline billing processes and improve workflow efficiency.
Pharmacy Technician
Cigna
Sioux Falls, SD
05.2014 - 01.2022
- Managed inventory levels to ensure adequate supply of medications and pharmacy products.
- Processed prescription orders accurately and efficiently, minimizing errors.
- Assisted pharmacists in preparing and dispensing medications according to established protocols.
- Trained new technicians on pharmacy procedures and best practices for customer service.
Education
Master of Science - Criminal Justice
Colorado Technical University
Colorado Springs, CO05.2015
Skills
- Strong communication skills
- HIPAA compliance awareness
- Effective written and verbal communication
- Leadership qualities
- Relationship building
- Continuous learning attitude
- Goal setting
Timeline
Provider Enrollment Specialist
Sanford
01.2022 - Current
Medical Biller
Accredo Specialty Pharmacy
01.2020 - 01.2022
Pharmacy Technician
Cigna
05.2014 - 01.2022
Master of Science - Criminal Justice
Colorado Technical University