Jacqueline Bonds

• Led provider enrollment and contracting processes, ensuring timely onboarding and compliance with Medicare, Medicaid, and commercial payer requirements. ( UHC, Cigna , Aetna, BCBS, Humana and other payer portals.
• Managed full-cycle credentialing for physicians and advanced practice providers, including initial onboarding, primary source verification (PSV), recredentialing, and ongoing compliance monitoring.
• Led team in training staff and reviewing work for accuracy, ensuring adherence to quality and productivity standards.

• Conducted regular audits of provider data, including NPI, Tax ID, licensure, DEA,specialties, practice locations, and demographics.

• Acted as the primary liaison between providers, payers, and internal teams, resolving enrollment discrepancies and communicating status updates.

• Tracked enrollment applications and contract lifecycle activities, confirming effective dates and ensuring readiness for reimbursement.

• Utilized CAQH ProView,PECOS,Availity,NPPES, CMS I&A, MD-Staff, Excel and Smartsheet to manage provider data, enrollment workflows, and system updates.

• Managed provider enrollment data through Salesforce and Smartsheet, documenting application status, payer effective dates, outstanding requirements, and follow-up activities.

• Led the team, guiding staff on credentialing and enrollment workflows, reviewing work for accuracy, and verifying compliance with productivity and quality standards.
• Navigated Blue Cross Blue Shield, Aetna, Cigna, Humana, UnitedHealthcare, NaviNet, and Optum Provider Express portals for enrollment and provider maintenance
• Prepared and submitted credentialing and enrollment applications, ensuring completeness and adherence to CMS and payer-specific requirements.
• Conducted detailed audits of provider records, including licensure, certifications, malpractice coverage, and demographic data to ensure compliance with regulatory standards.
• Coordinated with contracting, credentialing, and billing teams to resolve discrepancies, ensuring accurate provider onboarding and network participation.
• Managed provider outreach efforts, obtaining missing documentation, verifying information, and ensuring timely application processing.
• Generated reports on enrollment status, compliance metrics, and provider data accuracy to inform leadership decision-making.
• Generated reports on enrollment status, compliance metrics, and provider data accuracy, supporting leadership decision-making.
• Identified and implemented process improvements that streamlined enrollment workflows and enhanced turnaround times.

• Coordinated provider-to-group affiliations and roster submissions, enhancing accuracy of payer loading for billing readiness.
• Tracked and managed credentialing expirables (licenses, DEA, malpractice insurance) to prevent lapses in provider participation.
• Maintained accurate records of submitted documents and verifications, proactively managing expiration and reappointment cycles to initiate timely renewals.
• Tracked and managed credentialing expirables (licenses, DEA, malpractice insurance), ensuring continuous provider participation without lapses.
• Demonstrated expertise in ACO and MSO structures, supporting multi-state provider enrollment, contracting, and network expansion across national payer organizations.