Jessica Smith
Chandler,AZ
Overview
13
13
years of professional experience
Work History
Credentialing/ Medical Staff Office Manager
United Surgical Partners
Chandler
06.2019 - 07.2020
- Oversee Credentialing Staff and application processes, Create policies and procedures, Review NPDB Continuous Query, Review Sanctions Monthly, Medical Executive Committee and Governing Board Meeting Management, Assist with Joint Commission Survey preparation, Work closely with Medical Staff Leadership, Review and Revise Hospital Bylaws, Review and approve all applications submitted for Medical Staff Membership, Audit employees, Facilitate Medical Staff Education, Facilitate Payor Credentialing, Timecard Management, Corrective action counseling, Update and revise Delineation of Privileges for all specialties, Interim Medical Staff Office manager for sister hospital, Oasis, Interview Candidates, Train new employees
Credentialing Specialist
Banner Health CVO
Mesa
01.2019 - 06.2019
- Process reappointment applications, Facilitate corporate credentialing with various Banner locations, Primary source verification, Investigate claim denials, Assist with provider licensure
Credentialing Specialist
AB Staffing, LLC
Gilbert
12.2017 - 12.2018
- Facilitate credentialing process for Government Contracts, Obtain AMA & NPDB reports for all providers, Verify providers education, employment history and references, Process background check investigations, Cultivate working relationships with the providers, sales, payroll and upper management, Facilitate Medical Licensing process for providers obtaining new licensure
Credentialing Coordinator
Southwest Kidney Institute, PLC.
Tempe
01.2017 - 10.2017
- Work with MSO's & CVO for initial and reappointment credentialing process, Provider Enrollment with Commercial and Government Payors, Monitor Provider's CME's, Complete License initial and renewal applications (State license & DEA), Investigate Claim denials, Investigate Contract issues with various Payors, Audit Credentialing Team weekly, Assist Credentialing Manager with facilitating New Hire Training, Created and maintain department policies and procedures along with New Hire Manu
Regional Credentialing Coordinator- Hospital Professional Revenue
SSM Health
St. Louis
08.2016 - 11.2016
- Enroll providers with various Government health plans, Work closely with Physicians as well as Hospital & Corporate leadership, Maintain 30 files at minimum, Investigate and resolve various non-payment due to providers being non-par
Corporate Credentialing Coordinator/Corporate Benefits Assistant
Signature Medical Group
St. Louis
04.2016 - 07.2016
- Enroll physicians in Government & Commercial Insurance, Hospital privilege credentialing, DEA, State Licensure renewals, maintain CAQH for all Surgeons
Credentialing Coordinator
Interim Physicians, LLC
St. Louis
12.2013 - 04.2016
- Obtain AMA and NPDB reports, Verification of Physicians education, Affiliations & Practice detail, Obtain references, Maintain consistent communication with Physicians, CVO's & MSO's, Utilize various online resources to verify ECFMG, DEA and State Licensure, Obtain Malpractice Claims History, Obtain Case Logs/Procedure Logs, State Medical Licensing and Physician Assistant Supervisory Forms, DEA and CSR (BNDD) Licensure, Work under strict deadlines to make sure files are presented at the appropriate meetings and providers meet target start dates, Provide 24/7 availability to answer calls or emails from Providers and clients, Work on 20-30 file's simultaneously, Track CME's
Health Outreach Specialist / New Hire Mentor
WellPoint/Anthem BCBS
St. Louis
07.2012 - 12.2013
- Answer inbound as well as outbound calls, Use medical terminology to review health assessment question with members, Train and coach New Hires on policies and procedures, Adhere to HIPPA guidelines
Front Office Specialist/Personal Assistant to Orthopedic Surgeon
Concentra Medical Center
St. Louis
06.2012 - 04.2013
- Assist Specialist Doctors with office visit work ups (Orthopedic Surgeon, Hand Surgeon & Physiatrist), Certified DOT/Non DOT Drug Screen Collector, Room Patient's and take vitals, Facilitate Physical Therapy pre-employment evaluations, Pull and Prep Charts prior to all patient visits, Obtain approval for special testing such as MRI's, CT's & Bone Scans, Schedule Special testing and surgeries, Communicate with Work-Comp adjusters, Obtain Prior authorization for Physical Therapy, Train New hires
CSR- Enterprise Rent-a-Car, National Car Rentals & Alamo
Enterprise Holdings
St. Louis
01.2012 - 06.2012
- Make reservations, Customer service & billing issues
Team Captain/ Insurance Specialist
HDIS
Olivette
07.2010 - 10.2011
- Obtain Commercial insurance approval for Diabetic Testing supplies, Ship orders daily, Keep track of the orders shipped by each team member and provide updates to for the Vice President.
Patient Accounts/ Authorization Rep
Magellan Health Services
Maryland Heights
05.2009 - 10.2009
- High volume of inbound calls, 100 plus daily, Familiarity with several different health plans from all over the country, CPT and ICD 9 coding, HIPAA, Medical Terminology
Patient Accounts Rep
St. Johns Mercy Health Care
St. Louis
05.2007 - 08.2008
- Update patient demographic information, Produce daily productivity reports, Schedule appointments, Responsible for patients of several satellite location
Credentialing Manager
Foothills Sports Medicine and Physical Therapy
Phoenix
06.2021
- Provider Enrollment, Credentialing Software implementation, Facilitate Credentialing Onboarding process, Create policies and procedures, Roster maintenance, Medicare, Medicaid, and Commercial Provider Enrollment, Investigate Claim denials, Oversee Credentialing Staff, Conduct payor application audits, Employee Timecard Management, Department Hiring and training
Timeline
Credentialing Manager
Foothills Sports Medicine and Physical Therapy
06.2021
Credentialing/ Medical Staff Office Manager
United Surgical Partners
06.2019 - 07.2020
Credentialing Specialist
Banner Health CVO
01.2019 - 06.2019
Credentialing Specialist
AB Staffing, LLC
12.2017 - 12.2018
Credentialing Coordinator
Southwest Kidney Institute, PLC.
01.2017 - 10.2017
Regional Credentialing Coordinator- Hospital Professional Revenue
SSM Health
08.2016 - 11.2016
Corporate Credentialing Coordinator/Corporate Benefits Assistant
Signature Medical Group
04.2016 - 07.2016
Credentialing Coordinator
Interim Physicians, LLC
12.2013 - 04.2016
Health Outreach Specialist / New Hire Mentor
WellPoint/Anthem BCBS
07.2012 - 12.2013
Front Office Specialist/Personal Assistant to Orthopedic Surgeon
Concentra Medical Center
06.2012 - 04.2013
CSR- Enterprise Rent-a-Car, National Car Rentals & Alamo
Enterprise Holdings
01.2012 - 06.2012
Team Captain/ Insurance Specialist
HDIS
07.2010 - 10.2011
Patient Accounts/ Authorization Rep
Magellan Health Services
05.2009 - 10.2009
Patient Accounts Rep
St. Johns Mercy Health Care
05.2007 - 08.2008