Jessica Fleary
Margate,FL
Summary
Capable Contract and Provider Enrollment Manager with extensive background overseeing processes. Highly dependable, ethical and reliable leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence overall.
Overview
18
18
years of professional experience
Work History
Senior Credentialing & Contracting Manager
Integrated Dermatology Group
01.2019 - Current
- Developed all existing departmental metrics and processes to measure the success of the Credentialing Department
- And gauge areas for improvement
- Analyze current reimbursement fees, negotiate rates with payers and execute an array of payer contracts with health plans
- Across 31 states
- Created SOPs of current workflow processes within the Credentialing/Provider Enrollment Department
- Gather statuses and manage reporting tools to share Payor Credentialing, licensing or Credentialing Billing related denial
- Statuses for meetings with Executives, Operations and Billing Department
- Educate internal and external parties as needed to ensure the expectation on credentialing timelines to help guide decisions
- Of physicians and mid-level start dates
- Manage our physicians and mid-levels initial state license applications, DEA, CDS and renewals for multi-states
- Ensure timely review & compliance of over 300 providers CAQH database, NPPES, EDI, EFT, Medicare revalidations and
- Commercial payer quarterly attestation
- Lead and manage the Credentialing/Provider Enrollment department’s day to day operations, recruit, train, coach and discipline
- Staff when required
- Responsible for the credentialing payer process during the due diligence page of an acquisition of a new practice/group.
Credentialing Supervisor
Integrated Dermatology Group
01.2016 - 01.2019
- Responsible for leading the process and the provider enrollment team to ensure the payer enrollment and contracting process
- Was being handled timely for over 120 plus Medical Doctors and Physician assistants.
Credentialing Coordinator
Integrated Dermatology Group
01.2013 - 01.2015
- Responsible for the payer enrollment process into health plans for over 120 Medical Doctors and Physician assistants
- CAQH, license, DEA, CDS enrollment and maintenance
- Maintenance of the provider enrollment status reports.
Provider Enrollment Supervisor
Pediatrix Medical Group, Inc
01.2006 - 01.2012
- Responsible for the daily supervision of Provider Enrollment staff, who was responsible for enrolling providers in the health
- Plans necessary for the reimbursement of services rendered by our providers
- Reported department progress to upper management
- Developed specific goals and plans to guide staff
- Implemented long- and short-term programs to allow best performance and assure operational efficiency within the Department
- Fulfilled role as the plan’s resource to external providers and other Pediatrix staff regarding enrollment issues.
Education
Bachelors Degree -
Florida Atlantic University
Davie, FLAA Degree - Received- Human Resource Management
Broward Community College
Coconut Creek, FL2012
AS Degree - Received- Medical Administration
Atlantic Technical Institute
Fort Lauderdale, FL2000
Skills
- Management (15 years)
- Recruiting
- Provider Enrollment
- Hospital Privileges
- Contracting
- Payer Negotiation
- Training
- Coaching
- SOP Management
- Database Management
- Automation
- Physician Licensing
- EDI Enrollment
- 15 plus years in the medical field
- Detailed Oriented
- Operations Management
- Paralegal (Immigration)
- Notary
- Microsoft word/excel certified
Timeline
Senior Credentialing & Contracting Manager
Integrated Dermatology Group
01.2019 - Current
Credentialing Supervisor
Integrated Dermatology Group
01.2016 - 01.2019
Credentialing Coordinator
Integrated Dermatology Group
01.2013 - 01.2015
Provider Enrollment Supervisor
Pediatrix Medical Group, Inc
01.2006 - 01.2012
Bachelors Degree -
Florida Atlantic University
AA Degree - Received- Human Resource Management
Broward Community College
AS Degree - Received- Medical Administration
Atlantic Technical Institute
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