Jennifer Videan
Wyoming,MI
Summary
Provider enrollment specialist with expertise in optimizing enrollment processes across Medicaid, Medicare, and commercial payers. Proficient in CAQH and NPI systems, with strong communication skills and database management experience. Dedicated to enhancing client relationships and pursuing continuous professional development.
Overview
25
25
years of professional experience
Work History
Provider Enrollment Specialist, Account Manager
Symplr
04.2023 - Current
- Processed provider enrollment applications, ensuring compliance with regulatory requirements and internal policies.
- Coordinated with healthcare providers and provider staff to gather necessary documentation for credentialing and enrollment.
- Utilized enrollment management systems to track application status and maintain accurate records.
- Reviewed and verified provider data for accuracy, resolving discrepancies promptly to ensure seamless onboarding.
- Handled escalated enrollment cases with professionalism and tact, ensuring positive outcomes for both providers and the organization.
Provider Enrollment Specialist
Hope Network
02.2021 - 03.2024
- Managed provider enrollment processes to ensure compliance with regulatory requirements.
- Reviewed and verified application documents for accuracy and completeness.
- Coordinated communication between providers and internal departments to resolve inquiries.
- Maintained provider databases, ensuring up-to-date information for operational efficiency.
- Contributed towards policy updates by sharing insights from hands-on experience dealing with unique or challenging enrollment scenarios.
Provider Enrollment Specialist
Getixhealth
03.2007 - 02.2021
- Streamlined provider enrollment processes by implementing efficient data management systems.
- Contacted insurance carriers to obtain information regarding denials.
- Reviewed contracts thoroughly to ensure adherence to organizational policies and guidelines before finalizing provider agreements.
- Monitored credentials and contacted practitioners when expiration dates were nearing.
- Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.
- Reduced errors in provider applications with meticulous attention to detail and thorough review procedures.
- Managed high-volume caseloads effectively, prioritizing tasks to meet strict deadlines consistently.
- Maintained up-to-date knowledge on regulatory changes, ensuring compliance in all provider enrollments.
Medical Biller
GetixHealth
08.2003 - 03.2007
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collaborated with healthcare providers to clarify patient information, improving the accuracy of submitted claims.
- Resolved discrepancies in insurance claims through detailed analysis and follow-up communication with payers.
- Processed medical claims efficiently, ensuring accuracy in billing procedures.
Customer Service Representative
GetixHealth
08.2001 - 08.2003
- Resolved customer inquiries through effective communication and problem-solving techniques.
- Managed high-volume calls, ensuring timely response and resolution of issues.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Education
Associate of Science - Business Management
Davenport University
Grand Rapids, MISkills
- Communication skills
- HIPAA compliance
- Effective written and verbal communication
- Continuous learning
- Microsoft Office proficiency
- Billing software knowledge
- Project management
- Credentialing follow-up
- Client relationship management
- Provider enrollment expertise
Timeline
Provider Enrollment Specialist, Account Manager
Symplr
04.2023 - Current
Provider Enrollment Specialist
Hope Network
02.2021 - 03.2024
Provider Enrollment Specialist
Getixhealth
03.2007 - 02.2021
Medical Biller
GetixHealth
08.2003 - 03.2007
Customer Service Representative
GetixHealth
08.2001 - 08.2003
Associate of Science - Business Management
Davenport University