TBS
Kristen Simpson
Hubert,NC
Summary
Organized and dependable candidate adept at managing multiple priorities with a positive attitude. Willing to take on additional responsibilities to meet team goals. Proactive and goal-oriented professional with excellent time management and strong problem-solving skills. Recognized for reliability and adaptability, with a quick capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth. Demonstrates strong analytical, communication, and teamwork skills, with a proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Maintains a commitment to continuous learning and growth, prepared to start a career while making meaningful contributions with dedication and drive.
Overview
2025
2025
years of professional experience
Work History
Provider Enrollment Specialist
Trillium Health Resources
11.2021 - Current
- Maintain provider and practitioner profiles in TBS, proper documentation in TBS, and organized related documents on the P: Drive
- Completes onboarding processes for new practitioners and providers/agencies
- Manage KACE tickets and distribute Network Development tickets
- Providing assistance and troubleshooting KACE tickets for solutions and redirect tickets to the correct department to ensure providers receive excellent customer service
- Works closely with the contracts department as part of daily activities with KACE tickets and NARs
- Works with IT on assigned tasks as needed for development
- Assists with the Provider Enrollment inbox and assists providers in answering questions and concerns as needed
- Completes reports as needed
- Serves as backup for the team lead
- Attend workgroups and meetings regularly as well as record meeting minutes
- Reviews PEF and PNF for both behavioral health and physical health provider profiles for enrollments, status, and accuracy
- Always maintain a high level of confidentiality
- Completes data reports assigned by supervisor as needed
- Diligence and ability to work independently to complete all assigned tasks
- Prioritize in order of importance to meet deadlines with accuracy
- Ability to communicate with supervisors, coworkers, and providers by email, KACE ticket responses, Cisco Jabber, or by phone
- Take the initiative to step up and lead when available, lead the first All Network Staff Meeting
- I desire to continue to learn and grow within my role and explore any opportunities for cross-training and training to enhance my skill set
- Ability to adjust to and adapt to departmental changes, while maintaining a positive attitude
- I have completed primary source verifications, including background checks for new providers/practitioners
- Worked and problem-solved PEF Delta Report and PEF Termination and Suspension Report daily
Credentialing Manager
Coastal Carolina Neuropsychiatric Center
06.2014 - 10.2021
- Credentialing - Initiate provider credentialing, Maintain/Track provider credentialing/files and license expirations for over 50 providers
- Primary Source Verified credentials
- Maintained personnel files on all medical and allied health professionals including information related to demographics, education, licensures, licensure or clinical practice disciplinary actions, clinical practice restrictions, and medical malpractice suits, judgments, and settlements
- Obtained certificate of insurance for liability insurance for providers
- Provided requested reports as directed
- Worked closely with HR to complete new provider onboarding
- Worked closely with HR to obtain background checks and general liability insurance renewals for the practice
- Worked closely with Managers within different departments, including HR to help maintain provider schedules
- Performed administrative tasks such as document preparation, verbal, and electronic communication, copying, filing, using a database management system, overnight delivery service coordination, and project management
- Maintained a professional working relationship with hospitals and insurance companies
- Communicate with insurance on behalf of providers in a professional manner and maintain a high level of confidentiality
- Communicated effectively with all Providers, Clinical Staff, Insurance Carriers, Supervisors, Front Desk personnel, and patients
- Provided feedback and positive input
- Prioritize in order of importance to meet deadlines
- Effective communication with A/R manager with Credentialing status and maintained Group Credentialing for 5 practice locations
- Maintained provider's CAQH, used IntelliSoft Credentialing Program and obtained NPIs
- Communicated with the insurance carrier to ensure all practitioners' certificates of insurance were current and up to date
- Created employee handbook for credentialing
- Participated in requirements needed for CARF accreditation
- Attend meetings and documented meeting minutes
- Delegated workload and updated coworkers on any changes within the department
- Wrote required desktop protocols as needed
New Patient Intake/Authorization Specialist/Team Lead (Interim Supervisor)
- Delegated workload
- Updated coworkers on any changes within the department
- Train new employees
- 90-day and annual audits
- Run weekly/monthly/yearly reports
- Create spreadsheets
- Assist team members with questions
- Trained all new hires and assisted/answered other employees' questions
- Helped start/train for TMS program, and created manuals needed for all employees
- Provided benefit information to patients about the coverage of their policy
CNA/Medical Receptionist/Medical Secretary
Western Maryland Regional Medical Center
01.2010 - 04.2012
- Provided activities of daily living for patients
- Took patient vitals
- Maintained medical records and medical documentation
- Assisted with and performed procedures
- Prepared lab specimens
- Stocked and completed inventory
- Ordered supplies as needed
- Provided excellent customer service and quality assurance
- Scheduled appointments as needed
Education
Bachelor's Degree - Business Administration & Data Analysis
Liberty University
12.2024
Associate of Arts - Health Care Administration
University of Phoenix
04.2015
Skills
- Data analysis
- Reports
- Project management
- Verbal and written communication
- Organization
- Problem-solving
- Customer service and conflict resolution
- Leadership
- Documentation review and reporting
- Task delegation
- 10 years Insurance: Medicaid
- Decision-making
- Analytical thinking
- Complex Problem-solving
Software
KACE
NC Tracks
Cisco WebEx
Cisco Jabber
Microsoft Teams
CAQH
Availity
IntelliApp
Microsoft Outlook
Microsoft Word
Microsoft Excel
Microsoft Office
Microsoft PowerPoint
Windows Programs
Timeline
Provider Enrollment Specialist
Trillium Health Resources
11.2021 - Current
Credentialing Manager
Coastal Carolina Neuropsychiatric Center
06.2014 - 10.2021
CNA/Medical Receptionist/Medical Secretary
Western Maryland Regional Medical Center
01.2010 - 04.2012
Associate of Arts - Health Care Administration
University of Phoenix
New Patient Intake/Authorization Specialist/Team Lead (Interim Supervisor)
Bachelor's Degree - Business Administration & Data Analysis
Liberty University
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