Jennifer Nappi
Hudson
Summary
Dynamic Credentialing Manager at Premier Revenue Solutions with a proven track record in optimizing application processing and enhancing compliance. Skilled in data management and relationship building, I successfully reduced processing times by streamlining workflows, while fostering teamwork and mentoring junior staff to elevate operational efficiency.
Overview
11
11
years of professional experience
Work History
Credentialing Manger
Premier Revenue Solutions
11.2021 - Current
- Assisted in processing credentialing applications for healthcare providers.
- Learned to utilize credentialing software for efficient data management.
- Supported team in verifying licenses and certifications of medical staff.
- Contributed to maintaining compliance with industry regulations and standards.
- Engaged in training sessions on best practices for credentialing procedures.
- Collaborated with cross-functional teams to streamline onboarding processes.
- Documented procedural workflows to enhance operational efficiency within the department.
- Mentored junior team members on best practices in provider relations and customer service.
- Implemented a secure document storage system that improved confidentiality while ensuring easy access during audits.
- Managed the onboarding process for new providers, ensuring timely completion of all required documentation.
- Established strong relationships with external agencies, streamlining communication regarding provider credentials and facility statuses.
- Facilitated smooth communication between departments, fostering collaboration in support of credential management objectives.
- Reduced processing times for credential applications by optimizing workflow efficiency and staff allocation.
- Expedited the resolution of credentialing issues by liaising effectively with providers and external organizations.
- Developed comprehensive training materials for new hires, promoting consistency in credentialing processes across the organization.
- Developed performance metrics to monitor staff productivity, leading to increased efficiency throughout the department.
- Led team meetings to discuss progress toward goals, troubleshoot issues, and share best practices among colleagues.
- Coordinated closely with human resources to ensure seamless integration of hiring activities into the overall credentialing process.
- Improved data integrity by implementing rigorous quality control checks on all incoming documentation from providers.
- Collaborated with department leaders to develop policies and procedures for maintaining accurate provider records.
- Maintained up-to-date knowledge of industry regulations, ensuring ongoing adherence to best practices in provider credentialing.
- Demonstrated excellent problem-solving skills in identifying and resolving discrepancies in provider documentation, ensuring compliance with regulatory requirements.
- Conducted periodic risk assessments to identify potential vulnerabilities in credentialing workflows and implemented corrective measures as needed.
- Assisted with the preparation of reports for senior management, highlighting key achievements and areas for improvement within the department.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- Established team priorities, maintained schedules and monitored performance.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Assisted in organizing and overseeing assignments to drive operational excellence.
- Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
- Trained personnel in equipment maintenance and enforced participation in exercises focused on developing key skills.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
- Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
- Set aggressive targets for employees to drive company success and strengthen motivation.
- Developed detailed plans based on broad guidance and direction.
- Launched quality assurance practices for each phase of development
- Streamlined and monitored quality programs to alleviate overdue compliance activities.
Referral Coordinator
Quality Medical Associates
09.2014 - 11.2021
- Coordinated patient referrals to specialists, ensuring timely access to care.
- Managed appointment scheduling for multiple providers, improving patient flow and reducing wait times.
- Collaborated with healthcare teams to streamline referral processes, enhancing communication and efficiency.
- Maintained accurate patient records using electronic health record (EHR) systems, ensuring compliance with regulations.
- Provided support in verifying insurance coverage for referrals, facilitating seamless patient transitions.
- Analyzed referral patterns to identify areas for process improvement, contributing to enhanced operational effectiveness.
- Assisted in quality assurance initiatives by monitoring referral accuracy and resolving discrepancies promptly.
- Scheduled appointments with specialists on behalf of clients.
- Demonstrated strong attention to detail and organizational skills in managing a high volume of referrals while maintaining exceptional levels of patient care.
- Maintained a high level of accuracy in referral documentation, ensuring smooth transitions between healthcare providers.
- Processed referral requests from patients, doctors and other health care professionals.
- Responded to patient inquiries to offer timely updates regarding referral status.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Served as a liaison between primary care physicians, specialists, and patients to ensure timely access to needed services.
- Provided exceptional customer service, addressing patient concerns and inquiries regarding the referral process.
- Managed electronic health records efficiently, safeguarding sensitive patient information while expediting the referral process.
- Developed and maintained strong working relationship with referral sources to streamline processing.
- Established strong relationships with external providers, facilitating seamless communication and collaboration in patient care.
- Developed comprehensive knowledge of insurance requirements, advocating for patients when necessary to secure approval for needed services.
- Enhanced patient satisfaction with timely coordination of referrals and appointments.
- Kept healthcare providers informed of referral status updates, promoting optimal continuity of care throughout the referral process.
- Assisted with completion of referral forms and verified data accuracy and completion
- Monitored referrals to foster timely completion and followed up with physicians to facilitate.
- Facilitated referrals to other healthcare providers and resources to bridge service gaps.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Streamlined referral process by implementing efficient tracking and communication systems.
- Contributed to practice growth by maintaining positive relationships with both patients and referring providers.
- Weighed patient need, provider availability, and insurance coverage to determine optimal scheduling.
- Attended continuing education courses to stay current on referral processes and best practices.
- Collaborated with medical staff to ensure appropriate referrals based on individual patient needs and insurance coverage.
- Reduced wait times for specialist appointments by proactively identifying available slots and coordinating schedules.
- Contributed to patient education by providing relevant information about their referral process and expectations.
- Coordinated with insurance companies to verify coverage, facilitating smoother patient experience.
- Facilitated team-oriented approach to patient care, ensuring all stakeholders were informed about referral statuses.
- Assisted patients in understanding their referral plans, leading to enhanced patient compliance and satisfaction.
- Played key role in integration of new electronic health record system, focusing on referral management module.
- Optimized use of healthcare resources by efficiently managing referral appointments and follow-ups.
- Implemented tracking system for referral outcomes, enabling continuous improvement of referral process.
- Scheduled and confirmed referral appointments to reduce wait times for patients.
- Maintained accurate and up-to-date patient records, contributing to improved healthcare outcomes.
- Developed strong relationships with healthcare providers to ensure broad network of specialists for patient referrals.
- Fostered positive relationships with external healthcare facilities and specialists to expand referral options for patients.
- Supported healthcare providers with timely access to patient referral information, aiding in better clinical decision-making.
- Improved inter-departmental collaboration by establishing effective referral protocols.
- Discussed medical histories with patients in effort to provide most effective medical advice.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
Education
Associate of Arts - Health Care Management
Ultimate Medical Academy
Clearwater, FL02-2022
High School Diploma -
Saint Mary's
Manhasset, NY06-1992
Skills
- Provider enrollment
- Application processing
- Documentation review
- Accreditation compliance
- Background checks
- Data management
- Credential verification
- License monitoring
- Positive attitude
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Multitasking Abilities
- Reliability
- Excellent communication
- Computer skills
- Organizational skills
- Team collaboration
- Team leadership
- Active listening
- Effective communication
- Adaptability and flexibility
- Verbal and written communication
- Decision-making
- Problem resolution
- Relationship building
- Customer relations
- Team building
- Professional and courteous
- Task prioritization
- Work Planning and Prioritization
- Scheduling and coordinating
- Self motivation
- Managing operations and efficiency
- Interpersonal skills
- Customer relationship management
- Conflict resolution
- Hiring and training
- Employee training
- Recruitment and hiring
- Operations management
- Goal setting
- Team development
- Professionalism
- Good judgment
- Staff management
- Interpersonal communication
- Task delegation
- Quality control
- Complex Problem-solving
- Documentation and reporting
- Strategic planning
- Negotiation and conflict resolution
- Employee coaching and mentoring
- Schedule management
- Staff training
- MS office
- Preventive Maintenance
- Time management abilities
- Continuous improvement
- Adaptability
- Written communication
- Employee development
- Interpersonal relations
- Staff development
- Administration and reporting
- Performance evaluation
- Emergency response
- Professional demeanor
- Problem-solving aptitude
- Shift scheduling
- Performance management
- Onboarding and orientation
- Performance tracking and evaluation
- Process improvement
- Performance evaluations
- Performance reviewing
Timeline
Credentialing Manger
Premier Revenue Solutions
11.2021 - Current
Referral Coordinator
Quality Medical Associates
09.2014 - 11.2021
Associate of Arts - Health Care Management
Ultimate Medical Academy
High School Diploma -
Saint Mary's
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