Jennifer Unitas
West Haven
Summary
Dynamic Network Credentialing Specialist with proven success at SAFERIDE HEALTH, achieving 90% credentialing levels while ensuring compliance with Medicaid regulations. Skilled in relationship management and analytical thinking, I excel in cultivating partnerships and streamlining processes, driving client satisfaction and retention through effective communication and collaboration.
Overview
11
11
years of professional experience
Work History
Network Credentialing Specialist
SAFERIDE HEALTH
San Antonio
01.2023 - Current
- Successfully assisted in the Ohio and Michigan launches.
- Executing 90% of regulatory research on Medicaid requirements for providers
- Collaborated with legal department to ensure compliance with federal and state regulations.
- Participated in periodic audits of credentialing files to maintain compliance with applicable regulations and policies.
- Achieved 90% credentialing level for drivers and vehicles in targeted areas
- Validated provider insurance for compliance with required limits and documentation
- Executed internal credentialing reviews, risk assessments, and gap assessments to strengthen credentialing program
- Monitored credentialing practices, evaluating driver's credentials to ensure all qualifications were satisfied
- Coordinate efforts with internal and external partners to comprehend needs and create tailored solutions
- Interacted with providers and colleagues to secure compliance while preserving network adequacy
- Cultivated strong partnerships with transportation providers and swiftly resolved questions and issues.
Transportation Success Associate
ROUNDTRIP HEALTH
Philadelphia
01.2021 - 01.2022
- Communicated with clients using email, phone, and CRM software to analyze needs and maintain highest retention.
- Developed initiative to streamline cost approval procedures, safeguarding against $20,000 loss and conserving 1,300 working hours each year.
- Resolved client support issues, concerns, and feedback, achieving highest Net Promoter Score (NPS) with a 35% improvement.
- Established strong trust and respect with assigned clients (150-200) by spearheading successful onboarding, boosting adoption rates, client satisfaction, and enduring client partnerships.
- Achieved $32,500 in additional revenue through identification of up-sell opportunities.
Executed strategies to drive business outcomes and enhance client satisfaction.
Conducted assessments to guarantee clients achieved desired results. - Coordinated regular and prompt communication with clients and team members.
Customer Service Supervisor
NELSON AMBULANCE SERVICE
North Haven
01.2014 - 01.2022
- Directed call monitoring, coaching, training, corrective action, and review processes for all call taking staff.
- Maintained strict adherence to Medicare/Medicaid guidelines to mitigate denials and audits.
- Coordinated audits by assembling requested data, confirming accuracy throughout.
- Validated collection of all benefits, authorization requirements, and clinical notes accurately.
- Preserved extensive knowledge of payer guidelines, managing payer processes for initiating authorizations and ensuring follow-through for reimbursement retention.
- Examined patient records to verify authenticity of treatment and necessary level of care.
- Confirmed accuracy of data entered in computer-aided dispatch (CAD) and EHR/EMR software.
- Managed escalated customer calls related to billing inquiries, claim results, and benefit details.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
Education
High School Diploma -
East Haven High School
East Haven, CT06-2002
Skills
- CRM systems
- Client communication
- Relationship management
- Attention to detail
- Analytical and critical thinking
- Relationship building
- Detail-oriented
- Collaboration
- Empathy
- Client retention
- Leadership
- Communication
- Onboarding
Affiliations
- Southern New England Search and Rescue.
- Coach soccer for multiple at risk youth groups.
Timeline
Network Credentialing Specialist
SAFERIDE HEALTH
01.2023 - Current
Transportation Success Associate
ROUNDTRIP HEALTH
01.2021 - 01.2022
Customer Service Supervisor
NELSON AMBULANCE SERVICE
01.2014 - 01.2022
High School Diploma -
East Haven High School
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