Keli Kerr
Bermuda Dunes,CA
Summary
Dynamic leader with expertise in payer relations, billing, and credentialing. Streamlined processes to enhance operational efficiency, optimize reimbursement, and strengthen provider relationships. Strong communication skills support effective policy decisions and daily operations that drive business success.
Overview
1
1
Certification
24
24
years of professional experience
Work History
Director of Payor Relations
OCD Anxiety Centers LLC
South Jordan, Utah
08.2025 - Current
- Oversaw multi-state facilities to contract with top 20 insurance payors in each state.
- Cultivated relationships with payors to negotiate favorable contracting terms.
- Ensured contracts optimized reimbursement while safeguarding organizational interests and enhancing provider relationships.
- Interpreted and assessed contractual risk in provider agreements during high-stakes negotiations.
- Negotiated SCA and LOA agreements with payors.
- Created policies and processes to enhance the efficiency of contract review, approval, and execution across all facilities.
- Partnered with claims configuration, business development, and data management to align operations with contracting strategies.
- Drove root-cause solutions for systemic issues impacting contract performance and compliance.
- Delivered executive-level reports and strategic recommendations on network adequacy and financial implications of specialist capitation agreements.
Director of Billing and Payor Relations
Key Healthcare, LLC
Los Angeles, CA
04.2025 - Current
- Lead the negotiation process for payor contracts, including fee-for-service, value-based, and alternative payment models.
- Negotiate partner contracts to ensure alignment with payors, partnership objectives, and Key Healthcare, LLC. business goals.
- Developed contractual agreements with payors and providers to ensure compliance with regulatory requirements and alignment with provider and program policies.
- Provided expert advice on billing optimization strategies, leading to a reduction in outstanding accounts receivables.
- Implemented new billing system software, resulting in an increase in productivity.
- Ensured daily billing, denial tracking, appeals, and disputes are handled to maximize positive outcomes and claims payments.
- Managed and supervised billing department staff, including training, evaluation, and workflow distribution.
- Created comprehensive reports on billing activities, aging accounts receivable, and revenue collections to support strategic decision-making.
- Conducted market analysis to identify payor and provider trends, competitive landscape, and partnership opportunities, informing business development strategies.
Director of Credentialing and Payer Relations
Discovery Behavioral Health
Irvine, CA
02.2025 - Current
- Oversaw credentialing and contracting for the PPS Division.
- Managed submission of payer applications, ensuring timely processing to maintain enrollment timelines.
- Liaised with insurance companies to complete provider enrollment and ensure billing capabilities.
- Coordinated with healthcare professionals to gather documentation for credentialing, ensuring completeness and compliance.
- Ensured compliance with applicable laws, regulations, policies, procedures, and contracts related to Credentialing functions.
- Conducted thorough background checks and verified educational and professional qualifications.
- Reviewed credentials in a timely manner ensuring accuracy and compliance with regulatory requirements.
- Performed audits of credentialing files to ensure accuracy and completeness of documentation.
- Created reports regarding various aspects of the credentialing program such as license expirations or privileging status updates.
- Participated in credentialing committees, presenting cases and making recommendations.
- Facilitated interdepartmental communication to effectively resolve credentialing issues, enhancing overall workflow.
- Set up NPI numbers for providers and facilities and updated current profile information.
- Responded promptly to inquiries from internal departments regarding provider information or status changes.
- Monitored NPDB and conducted PSV checks.
Director of Billing and Credentialing
Discovery Behavioral Health
Irvine, CA
02.2024 - 02.2025
- Coordinated with healthcare professionals to collect necessary documentation for credentialing.
- Ensured compliance with applicable laws, regulations, policies, procedures, and contracts related to Credentialing functions.
- Created reports regarding various aspects of the credentialing program such as license expirations or privileging status updates.
- Set up NPI numbers for providers and facilities and updated current profile information.
- Participated in credentialing committees, presenting cases and making recommendations.
- Facilitated communication between departments to resolve credentialing issues efficiently.
- Conducted thorough background checks and verified educational and professional qualifications.
- Reviewed credentials in a timely manner ensuring accuracy and compliance with regulatory requirements.
- Performed audits of credentialing files to ensure accuracy and completeness of documentation.
- Monitored provider compliance with CAQH and NPPES to ensure adherence to industry standards.
- Trained staff in billing systems and procedures to ensure compliance with standards.
- Facilitated monthly training sessions for billing department staff on new billing procedures and technologies.
- Monitored accounts receivables to ensure timely payments from customers.
- Analyzed billing processes, recommending improvements to reduce cycle time and enhance customer satisfaction.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Conducted regular performance appraisals for subordinates through verbal, written, and ongoing reviews to support staff development.
- Coordinated with external auditors during annual reviews of financial statements.
- Analyzed current billing processes for areas of improvement and cost savings opportunities.
- Responded promptly to inquiries from internal departments regarding provider information or status changes.
- Recruited, interviewed and selected employees to fill vacant roles.
- Verified licensure, education, certification, and malpractice insurance coverage to meet accreditation standards.
- Liaised with insurance companies to complete provider enrollment and ensure billing capabilities.
Billing Resolution Lead/Contracting and Credentialing Specialist
Anew Era TMS a part of Discovery Behavioral Health
Palm Desert, United States
12.2021 - 02.2024
- Managed billing collections and secured authorizations for patient services, optimizing revenue flow.
- Conducted billing audits and collections for 16 practices in California and Texas, enhancing accuracy in financial reporting.
- Managed patient accounts across multiple practices in California and Texas.
- Credentialed and contracted 16 practices in California and Texas, ensuring compliance with industry standards.
- Corresponds with licensing boards, CAQH and maintains overall accuracy of credentialing information
- Verifies and maintains all network, individual and/or facility provider information
- Monitors disciplinary actions, and follows up accordingly
- Reviews and identifies credentialing and/or re-credentialing practitioners in accordance with company guidelines
- Maintains all information regarding group contracts
Financial Officer
Old Town Optix Optometry
La Quinta, United States
06.2019 - 11.2021
- Compiled daily financial reports and day sheets to track revenue and operational performance.
- Executed medical billing and coding tasks to ensure timely reimbursement and compliance.
- Executed billing for durable medical equipment and Medicare claims.
- Processed patient orders efficiently in a fast-paced environment.
- Coordinated patient referrals to streamline patient care and improve service delivery.
- Responsible for scheduling appointments, checking in patients, following up with patients
- Entering patient co-pay, material order charges
Office Manager
Inland Pipeline
Beaumont, United States
02.2003 - 06.2019
- Managed office operations, including payroll and benefits administration.
- Streamlined bid report process, improving turnaround time for submissions.
- Delivered customer service support through extensive phone interactions, addressing inquiries and concerns.
- Oversaw organization of jobs database for streamlined access
Education
Associate of Science - Medical Billing And Coding
Laurus College
Santa Maria, California, United States06-2019
Skills
- Provider Contracting
- Provider Credentialing
- Claims processing
- Managed care contracts
- Contract negotiation
- Contract management
- Payer relations
- Claims Optimization
- Billing efficiency
- Medical Billing
- Report generation
- Credentialing management
- Credential verification
- NPDB, PSV Checks
- Data management
- Application coordination
- HIPAA
- Healthcare Compliance
- Risk assessment
- Medicare
- EDI transactions
- HCPCS coding
- Team leadership
- Attention to detail
- Stakeholder Engagement
- Relationship building
- Partnership Development
- Strategic planning
- Contract Strategy
- Problem-solving aptitude
- Strategic planning
- Contract Strategy
- Relationship building
- Partnership Development
Extracurricular Activities
I was a volunteer with the American Heart Association. I love reading, cooking and music.
Awards
Honor Roll, Honor Roll at Laurus College 2017
Work Authorization - Authorized Countries
United States
Certification
- Currently pursuing AAPC CPC and CPB certification.
References
References available upon request.
Timeline
Director of Payor Relations
OCD Anxiety Centers LLC
08.2025 - Current
Director of Billing and Payor Relations
Key Healthcare, LLC
04.2025 - Current
Director of Credentialing and Payer Relations
Discovery Behavioral Health
02.2025 - Current
Director of Billing and Credentialing
Discovery Behavioral Health
02.2024 - 02.2025
Billing Resolution Lead/Contracting and Credentialing Specialist
Anew Era TMS a part of Discovery Behavioral Health
12.2021 - 02.2024
Financial Officer
Old Town Optix Optometry
06.2019 - 11.2021
Office Manager
Inland Pipeline
02.2003 - 06.2019
Associate of Science - Medical Billing And Coding
Laurus College