Jessi Howard
Merrill,WI
Summary
Supported credentialing and enrollment processes with over 9 years of experience in healthcare services. Assisted in maintaining compliance with HIPAA, NCQA, and JCAHO regulations. Utilized knowledge of billing and claims systems to facilitate Medicare and Medicaid enrollment and revalidation processes.
Overview
13
13
years of professional experience
Work History
Enrollment Recovery Specialist
Privia Health
02.2024 - Current
- Completed Payer enrollments for providers in Maryland, DC, West Virginia, Ohio and Connecticut
- Engaged with healthcare providers to ensure seamless enrollment experiences for clients.
- Implemented process improvements to streamline enrollment workflows and reduce turnaround time.
- Facilitated training sessions and created User Guides for new staff to enhance understanding of provider enrollment and compliance requirements.
- Collaborated with cross-functional teams to resolve issues related to provider credentialing and enrollment status.
- Handled escalated enrollment cases with professionalism and tact, ensuring positive outcomes for both providers and the organization.
- Managed provider enrollment processes to ensure compliance with regulatory standards.
- Updated billing system to release claims as payer approvals were received
- Updated and maintained payer registration tasks in billing system for multiple markets
Credentialing and Enrollment Coordinator
Ascension
02.2016 - 12.2023
- Assured compliance with Contracted & Government health plan requirements
- Collected, Analyzed & Reported data by use of trackers and Excel Spreadsheets
- Maintained up-to-date data for each provider in credentialing databases and online systems
- Strong knowledge of NCQA guidelines, Primary Source Verifications & Payer Delegation
- Wrote team Policies, Procedures & New Hire Handbook
- Team Lead of several projects including Tax Id Merge, MD Staff Build for Columbia St Mary's Medical Group & Transition of EMR systems for Ascension WI
Government Billing & Follow up Specialist
Ministry Health Care
04.2013 - 01.2015
- Processed, adjusted, and tracked claims including denials, appeals & settlements
- Provided assistance as a Subject Matter Expert
- Effectively communicated with Internal and External contacts to ensure timely billing & processing of claims.
- Maneuvered between 8-10 computer systems at a time
- Participated in Lean Six Sigma projects and Hiring process of new employee
- Completed 12 month training course in Billing & Follow Up with a focus on Management
Education
Bachelor's degree - Healthcare Management
Rasmussen University
01.2016
Skills
Provider enrollment
HONORS & AWARDS
Lean Six Sigma, HIPAA Associate (HIPAAA) Certification, Consistent positive feedback from Internal Associates and Leadership
Timeline
Enrollment Recovery Specialist
Privia Health
02.2024 - Current
Credentialing and Enrollment Coordinator
Ascension
02.2016 - 12.2023
Government Billing & Follow up Specialist
Ministry Health Care
04.2013 - 01.2015
Bachelor's degree - Healthcare Management
Rasmussen University