JAMI ANDERSON
Grove,OK
Summary
CPCS certified credentialing professional with solid expertise in managing and verifying credentials for healthcare providers. Strong focus on team collaboration and achieving results. Reliable and adaptable, meeting organizational standards and compliance requirements. Skilled in data management, regulatory compliance, and communication.
Overview
8
8
years of professional experience
1
1
Certification
Work History
CREDENTIALING SPECIALIST (FREELANCE)
Go Staffing
06.2024 - Current
- Creating credentialing processes and forms for a start up company.
- Collaborating with internal teams to streamline credentialing workflows and improve efficiency.
- Revising current documentation to include applications, reference forms, and contracts.
- Maintaining compliance with credentialing standards and regulations.
- Processing the credentialing for physicians, NPs, and PAs for locum tenens assignments.
COMPLIANCE LIAISON II
Aya Healthcare
10.2023 - 05.2024
- Served as the primary point of contact, fostering strong relationships between internal teams and external partners.
- Coordinated multiple projects simultaneously, ensuring timely completion and alignment with organizational objectives.
- Managed regulatory compliance programs and audits for a Fortune 500 company.
- Averaging a 97% on-time start rate for 2023 and 98% for the first quarter of 2024.
- Continued all Compliance Liaison I activities.
COMPLIANCE LIAISON I
Aya Healthcare
10.2022 - 10.2023
- Upheld a high degree of professionalism at all times, representing the organization with integrity in both internal and external interactions.
- Conducted internal and external meetings to address upcoming challenges and provide solutions.
- Performed a biweekly auditing project for management, which consists of hundreds of records for a team of 15.
- Served as the main point of contact for clients/facilities, providing excellent customer service and promptly resolving any credentialing-related issues or concerns.
- Maintained compliance records and documentation.
INSURANCE NETWORK HEALTH ADMINISTRATOR
MDVIP
01.2022 - 09.2022
- Conducted data analysis to identify trends and make data-driven decisions.
- Provided guidance to physician's based on insurance principles, regulations, and department policies and procedures to ensure consistency regarding implementation of processes and best practice outcomes.
- Continued processing applications for credentialing affiliates with payers (insurance contracting).
- Composed persuasive appeal letters to negotiate physician's' payer contracts.
- Collaborated with cross-functional teams to streamline workflows and improve patient outcomes.
INSURANCE SERVICES COORDINATOR
MDVIP
07.2019 - 12.2021
- Provided exceptional customer service and support to resolve client issues and concerns.
- Trained and mentored new staff on insurance services protocols and procedures.
- Assisted with updating CAQH and processing applications in Pecos and Availity.
- Created and maintained more proficient processes, including SOPs (Standard Operating Procedures).
- Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
CREDENTIALING SPECIALIST
All Star Healthcare Solutions
02.2017 - 07.2019
- Managed multiple priorities effectively, resulting in on-time completion of credentialing tasks for numerous providers simultaneously.
- Communicated with providers to gather necessary documentation and information for credentialing.
- Maintained credentialing database and updated provider information as needed.
- Collaborated with internal departments to resolve credentialing issues and ensure timely processing.
- Successfully trained three Credentialing Specialists.
- Created training material and processes that resulted in faster, more efficient outcomes for the internal team and providers.
HEALTHCARE RECRUITER
All Star Healthcare Solutions
04.2016 - 02.2017
- Managed relationships with healthcare professionals and built a strong network for sourcing candidates.
- Proficient in utilizing recruitment software to track applicants and manage job postings.
- Conducted phone interviews to assess applicants. relevant knowledge, skills, experience and aptitudes.
- Utilized social media sites to recruit providers.
Education
BACHELORS IN BUSINESS ADMINISTRATION -
Hesser College
Manchester, NH05.2002
Skills
- Clear Communication
- Time Management
- Problem-Solving
- Data Integrity / Management
- Deadline Driven
- HIPAA Compliance
- Attention to Detail
- Critical Thinking
- Auditing
- Primary Source Verifications
Certification
NAMSS Certified Provider Credentialing Specialist, 03/01/22, Present
Volunteer Experience
- VFW Auxiliary Member, 10/01/22, Present
- VFW Auxiliary Coordinator and Trustee, 10/01/22, 07/01/23
- American Foundation of Suicide Prevention (AFSP), 10/01/21, Present
References
References and recommendation letters available upon request.
Timeline
CREDENTIALING SPECIALIST (FREELANCE)
Go Staffing
06.2024 - Current
COMPLIANCE LIAISON II
Aya Healthcare
10.2023 - 05.2024
COMPLIANCE LIAISON I
Aya Healthcare
10.2022 - 10.2023
INSURANCE NETWORK HEALTH ADMINISTRATOR
MDVIP
01.2022 - 09.2022
INSURANCE SERVICES COORDINATOR
MDVIP
07.2019 - 12.2021
CREDENTIALING SPECIALIST
All Star Healthcare Solutions
02.2017 - 07.2019
HEALTHCARE RECRUITER
All Star Healthcare Solutions
04.2016 - 02.2017
BACHELORS IN BUSINESS ADMINISTRATION -
Hesser College
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