Jennifer Cisneros
Burleson,USA
Summary
Professional with in-depth experience in healthcare operations and provider enrollment. Skilled in navigating complex regulatory requirements, ensuring compliance, and streamlining processes for efficiency. Strong focus on team collaboration and achieving results, adaptable to changing needs. Known for exceptional organizational skills, problem-solving abilities, and effective communication.
Overview
17
17
years of professional experience
Work History
Provider Enrollment Specialist
Vesta Healthcare
04.2024 - 12.2024
- Coordinated with internal departments to resolve any discrepancies or issues
- Reviewed and processed enrollment applications for health care plans
- Prepared reports related to enrollment activities and trends for management review
- Extracted reports and created provider database management templates in Google Suite while company was shopping around for a new vendor
Revenue Cycle Management Liaison
ACCESS TELECARE
09.2022 - 04.2024
- Works to bridge information transfer between the CLP and RCM teams and create a summary of multispecialty provider and group information needed for payer insurance enrollment with our external enrollment business partner
- Access Manager for CMS - initiates surrogacy requests upon providers being internally approved
- Works with providers and other internal employees to complete information requests as needed
- Data Entry of provider and enrollment data in Athena
- Communicate internal requests with vendor
- Completes EDI, ERA, and EFT enrollments as assigned with available information across three entities with over 500 providers with varying specialties across 42 states (hospitalist, cardiology, neurology, nephrology, psychiatry, pulmonary critical care, infectious disease, maternal-fetal medicine)
Provider Enrollment Team Lead
ACCESS TELECARE
09.2021 - 09.2022
- Trains new team members on current enrollment and company processes
- Works closely with Revenue Cycle to ensure accurate data is reflected in billing software (Athena)
- Assisted with payer contracting as requested
Provider Enrollment Specialist
ACCESS TELECARE
09.2020 - 09.2021
- Research enrollment process for new states
- In charge of payer contracting and making sure that all pertinent information is shared with necessary stakeholders across all departments
- Compiles documents as necessary for the enrollment process and effectively maintains data across Salesforce and Box to ensure accuracy
- Special projects as assigned such as auditing and ensuring all files were complete and ready to present to Joint Commission
- Trained other team members on steps for individual enrollment to add new providers for executed contracts that I had established for the group and created instructions in Salesforce for this function to reference as needed
Travel Team Credentialing Specialist
APOGEE PHYSICIANS
02.2020 - 09.2020
- Assigned to Apogee's Travel Team and helped maintain 46 providers' state and federal licenses and initiate their hospital privileges
- Created and maintained professional relationships with each medical staff office for every hospital contracted with Apogee - over 75 hospitals
- Helped implement and create more organized communication for all credentialing specialists to have a source of truth for site credentialing data
Credentialing Specialist
APOGEE PHYSICIANS
12.2017 - 02.2020
- Primary point of contact for all credentialing needs for up to 17 sites and maintained all credentialing standards specific to hospital by-laws for contracted hospitals for both full-time employees and independent contractors
- Assist contracted healthcare providers in obtaining their state and federal licenses per local, state, and federal guidelines for 5 states
- Helped open 5 different hospitalist programs
Associate Managing Patient Information Coordinator
APOGEE PHYSICIANS
05.2016 - 02.2018
- Administrative Assistant to the Director of Non-Clinical Operations and 8 Managing Patient Information Coordinators that oversee the day-to-day operations for over 75 hospitals
- Created and maintained spreadsheets and reports on a bi-weekly, monthly, quarterly, and yearly basis that included vital program and employee information for implementations, ongoing maintenance, and contract closures
- Reviewed Locum invoicing and contracts to extrapolate data to send to our contracted hospital's CMOs to approve payments based on the individual providers for multiple Locum companies
- Coordinated learning bulletins for the director with marketing to update all stakeholders for changes in policies, billing and coding requirements, training needs for the PICs and billing teams
- Kept records on all Patient Information Coordinators across the company to train, test, and maintained records for raises and bonuses daily
- Reviewed resumes for Patient Information Candidates for our Managing Patient Information Coordinators for their final review before setting up interviews to hire and sending them to HR for onboarding
- Helped keep track of all site openings and closings and maintained checklists for each department
Receptionist
JEFFERSON HARMON & ASSOCIATES
01.2016 - 04.2016
- Provided temporary relief to accounting firm during Tax Season
Office Manager
BRADLEY CHIROPRACTIC
02.2009 - 01.2016
- In charge of all day-to-day front and back office functions as required to run a Chiropractic Clinic as a sole employee during the last 5 years of employment
- Obtains patients' vital signs and performs all patient physical therapies including rehab, whole body vibration system, cold laser, ultrasound, electric muscle stimulation, spinal decompression
- Medical Records Clerk - Organizes files, developed spreadsheets, marketing, and intake forms, fax reports, and scan documents
- Answered multi-line phones, schedule, and greet patients
- CAQH attestation and additional re-credentialing requirements per insurance companies as requested (BCBS, Cigna, Medicare)
- Contact insurance providers to verify correct benefit information and obtain pre-authorization for necessary procedures
- Manages medical supply inventory, insurance records, and company files both physical and digital
- Maintained the doctor's professional relationships with DME and supplement vendors
- RCM end to end - Medical coding, billing, and collections for all insurance, workers' comp, personal injury, and cash cases
- Proofread all the doctor's correspondence with attorneys and insurance companies
- Handles social marketing campaigns via the company website, constant contact, and Facebook
- Successfully planned and implemented office move in September 2009
Chiropractic Assistant
RUNNELLS AND BRADLEY CHIROPRACTIC
11.2007 - 02.2009
- Managed receptionist area, including greeting patients and responding to telephone and in-person requests for information
- Insurance verifications
- Created HCFAs to submit claims to payers
- Medical records clerk
- In charge of carrying out all patients' physical therapy per doctor's instructions
Education
BS - Healthcare Management
Walden University
Minneapolis, MN05.2023
Certified Massage Therapist -
ATI Career Training Center
Hurst, TX05.2008
Stephen F. Austin State University
Nacogdoches, TX05.2007
Skills
- Insurance Provider Enrollment
- Licensing and Credentialing
- Client Support
- Comprehensive Account Coordination
- Reporting and Analytics
- Vendor Coordination Expertise
- Effective Performance Under Pressure
- Policies and procedures implementation
- Multidisciplinary collaboration
- Multitasking
- Problem-solving aptitude
- Operational Efficiency Enhancement
- Proficient in Interpersonal Communication
- HIPAA compliance awareness
- Data entry proficiency
- Special projects
- Results-driven approach
- Continuous learning attitude
- Flexible and adaptable
- Attention to detail
Timeline
Provider Enrollment Specialist
Vesta Healthcare
04.2024 - 12.2024
Revenue Cycle Management Liaison
ACCESS TELECARE
09.2022 - 04.2024
Provider Enrollment Team Lead
ACCESS TELECARE
09.2021 - 09.2022
Provider Enrollment Specialist
ACCESS TELECARE
09.2020 - 09.2021
Travel Team Credentialing Specialist
APOGEE PHYSICIANS
02.2020 - 09.2020
Credentialing Specialist
APOGEE PHYSICIANS
12.2017 - 02.2020
Associate Managing Patient Information Coordinator
APOGEE PHYSICIANS
05.2016 - 02.2018
Receptionist
JEFFERSON HARMON & ASSOCIATES
01.2016 - 04.2016
Office Manager
BRADLEY CHIROPRACTIC
02.2009 - 01.2016
Chiropractic Assistant
RUNNELLS AND BRADLEY CHIROPRACTIC
11.2007 - 02.2009
Certified Massage Therapist -
ATI Career Training Center
Stephen F. Austin State University
BS - Healthcare Management
Walden University
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