
Detail-oriented healthcare professional with extensive experience in provider credentialing and project management. Proven ability to manage end-to-end credentialing processes, ensure regulatory compliance, and coordinate cross-functional teams to meet organizational skills.
● Client services, implementation and on boarding, managed team of 60 employees, onshore and offshore teams.
● Privileging, credentialing, re-credentialing, initial enrollments with payers in many states to include AK, AZ, CA,TX, IL, MA, RI, NY, MS, LA, PA, NJ, GA, KY, OH, and AL.
● Management of provider portals including PECOS, NPPES, CAQH, Availity and more
● Provider Enrollment Supervisor responsibilities include coaching and training on multiple payer platforms,troubleshooting enrollment issues, resolving AR issues and claim denials, onboarding new provider enrollment specialists, employee reviews and productivity tracking, creating and maintaining payer SOPs, generating and maintaining reports for clients and supervisors, auditing claim issues and resolving
● MCO management and client services, implementation and client onboarding. Managing a team of 9 employees
● Hospital and ASC Privileging, credentialing, re-credentialing, initial enrollments in AZ, CO, MD and TN markets.
● Provider Licensing Management
● Management of provider portals including PECOS, NPPES, CAQH, Availity and more
● Provider Enrollment Supervisor responsibilities include coaching and training on multiple payer platforms, troubleshooting enrollment issues, onboarding new provider enrollment specialists, employee reviews and productivity tracking, creating and maintaining payer SOPs, generating and maintaining reports for clients and supervisors, auditing claim issues and resolving