LA KISA DAVIS

Work History

Clinical Operations Manager

Spora Health

Virginia Beach, VA

12.2021 - Current

Communicated effectively with staff members, physicians and patients, employing active listening and interpersonal skills.
Regularly evaluated employee performance and provided feedback.
Oversaw overall operation of nursing services and patient care.
Identify opportunities to improve clinical practices, devise strategies and implement plans to increase patient care standards and enhance operational procedures.
Delegated tasks to staff members, monitored completion of all duties and provided support to enhance performance.
Implemented onboarding process for new employees, which enabled each to effectively learn tasks and job duties, which lead to providers being ready to see patients sooner.
Deliver effective onboarding and training to new and existing employees and cross-train staff members in other job roles to maximize coverage.
Review operational policies and recommend solutions and change to Chief medical Officer
Partnered with Business Development to ascertain hiring needs and subsequently provide candidate recommendations.
Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency.
Enrolled providers and Medicaid, Medicare and private insurance plans.
Obtained NPI numbers for providers and facilities and updated existing profiles.
Received and evaluated applications to look for missing and inaccurate information.
Conducted primary source verifications such as background checks and board certifications.
Assisted with physician recruitment by identifying specific providers within designated territories, negotiating rates for new physicians and distributing provider agreements, successfully recruiting 19 new physicians per 6 week intervals as we launch into new states.
Contributed to and enhanced audit processes to maximize quality management standards.
Increased provider satisfaction scores 17% by collecting and credentialing demographic updates, investigating 110 claims and inquiries per week and overseeing network integrity.
Assist in research and resolve disputes, billing discrepancies and claims efficiently to maintain customer satisfaction.
Managed provider relations mailbox by triaging inquiries, facilitating resolution of incoming requests and forwarding requests to appropriate parties.
Foster strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying collaborative opportunities.
Answer provider inquiries per daily via email, telephone and written correspondence.
Identified network gaps and collaborated with Revenue Cycle Management to fill deficiencies.
Facilitate hiring of qualified Provider Operations personnel by interview applicants and making recommendations for employment.
Developed and adjusted work schedules for Allied Health staff.

Provider Credentialing Consultant

KD Consulting and Coaching Services LLC

Las Vegas, NV

07.2021 - Current

Primarily focused on Medical/Telehealth Office Start Ups, Credentialing, Contracting and Privileging.
Oversaw team of 6
Project milestone completion and quality of work performed.
Secured continuous contracts, aligned with the objectives and modifications made to enhance effectiveness toward intended results
Worked closely with Clinical Operations teams to ensure client satisfaction.
Tracked costs and expenses and assessed closely against contract budgets.
Defined scopes, managed resources and oversaw schedules in line with contract requirements.
Evaluated, monitored and reported on work progression, while verifying compliance was upheld at all times.
Monitored milestones and deliverables to stay ahead of schedules and proactively spot potential roadblocks.
Negotiated to secure favorable quotes and contracts for expedited services if required.
Assigned specific tasks to specialists, balancing scheduling demands, available resources and specialist skill sets to achieve best possible contract outcomes.
Protected budget by tracking expenses and intervening to prevent overpayments or misuse.
Updated contract based on changing objectives, number of health plans and specialist availability.
Maintained close connection with CVO,MSO, Payors and Specialists to quickly identify and resolve problems.
Procured software, required to meet contract demands.
Led strategic planning sessions for time and budget management.
Completed thorough risk assessments and deployed network reps, specialists and response strategies to prevent roadblocks.
Streamlined operational efficiencies by creating employee schedules, managing payroll, organizing appointments and executing contract compliance procedures.
Kept project teams on-task with proactive control of schedules
Identified, addressed and either resolved or escalated contract issues.
Maintained project schedules by managing deadlines and adjusting workflow.

Sr. Contracting & Credentialing Specialist

Dispatch Health

Denver, CO

04.2021 - 12.2022

Conducted primary source verifications such as background checks and board certifications.
Received and evaluated applications to look for missing and inaccurate information.
Enrolled providers and Medicaid, Medicare and private insurance plans.
Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency.
Maintained accurate files, records and credentialing documents in well-maintained databases using Cactus and MSOW.
Communicated effectively with various parties each day using polished interpersonal and active listening skills.
Assisted with managed care auditing processes and performed internal file audits.
Worked closely with practitioners to help each obtain privileges at assigned healthcare facilities
Tracked expiration dates on documents and communicated with appropriate staff to avoid late filing.

Lead Credentialing & Privileging Specialist

Unlv Medicine

Las Vegas, NV

04.2018 - 07.2021

Performed primary source verifications such as criminal histories, licenses and board certifications.
Maintained informational resources, tracking and documenting requests for updates, certification, privileging and credentialing.
Processed documents and status-change requests, conducted followup assessment regarding credentialing, enrollment and privileging inquiries.
Set up NPI numbers, Licenses, and DEA Certifications for providers and facilities and updated current profile information.
Completed enrollments into Medicaid, Medicare and private insurance plans.
Coordinate the Onboarding processes with the Quality Improvement Department and other internal departments, as necessary
Prepare Initial Appointments and re-appointment ﬁles necessary to align with monthly Medical Committee Meetings, external audits by health plans or governmental agencies.
Perform duties and responsibilities assigned, Orient new staﬀ to appropriate database use, capabilities, security.
Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
Tagged documents according to tiered access thresholds, updating packets, reviewing reports and forwarding items requiring approval or verification.
Checked applications for missing information and organized all paperwork.

Privileging Consultant

Sound Physicians

Westlake, TX

03.2016 - 04.2018

I am responsible for organizing, maintaining, and verifying all aspects of the credentialing process for healthcare practitioners in a health care-related facility, across 17 different states.
In all credentialing activities, I must comply with all legal and regulatory policies and procedures
Ensure credentialing, full or mini, for designated contractors in an organization
I maintain knowledge of jurisdictional requirements and document credentialing changes as needed
I communicate credentialing requirements and documents as needed.
Checked applications for missing information and organized all paperwork.

Private Medical Office Consultant

CAEMED MANAGEMENT LLC

Dallas, TX

10.2014 - 04.2018

Traveling , consulting , Identified problems with private medical practices, planned solutions using multidisciplinary approach to improve outcomes.
Collaborated with managers & employees of Private Health care teams to coordinate and implement policy's and procedures, for an efficient, seamless process
Train and coach teams of front and backs office medical assistants while implementing SOP's
Participated in team meetings to improve workflows and contribute to improving patient population outcomes.
Train and Maintain compliance with laboratory, company and legal regulations.
Reviewed completed work to verify consistency, quality and conformance.
Identified and corrected payment problems involving patients or third-party payers.
Introduce revenue cycle processes, working to maximize profitability and increase revenue.
Boost job efficiency by working closely with staff and analysts so that tasks and processes could be streamlined and duplication is avoided.
Increase overall efficiency of standard practices through design and development of improved policy and expedited procedures.
Collaborated with vendor and staff to gather data sources and expedite billing.

Credentialing Specialist

Provide Lt Locums Tenens

Frisco, TX

11.2017 - 03.2018

Processed New Locums Providers, Onboarding, credentialing,
Performed primary source verifications such as criminal histories, licenses and board certifications.
Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
Completed enrollments into Medicaid, Medicare and private insurance plans across various states
Worked closely with recruiters and CVO, MSO.

Medical Assistant Supervisor

HCA Healthcare

Las Vegas, NV

01.2016 - 05.2017

Back Office Lead Certified MA, effeciently coordinates training, staffing, continuity of patient care, assist physicians or mid-level practitioners, injections, phlebotomy, IV's,, triage, patient history intake, performs selected administrative duties, EMR training,
OSHA/CLIA training, effectively demonstrate teamwork, and adhere to Code of Conduct and Mission and Value Statement
Maintained safe work environment by wearing personal protective equipment.
Entered data from analysis of medical tests or clinical results into computer for storage.
Managed departmental inventory and supply ordering.
Performed various tests on patients to assess needs and medication effectiveness.
Provided technical information about test results to physicians, family members or researchers.
Reviewed safety, health and sanitation processes throughout areas and enforced rules to promote security and safety.
Met budget targets and quality standards by proactively leading team members and monitoring operations.
Orchestrated staff meetings to maintain open communication and quickly address concerns.
Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
Navigated through multiple online systems to obtain documentation.
Liaised between physician, site of service and billing department to obtain appropriate documentation.

Clinical Administrator/Manager

UNITED CRITICAL CARE LUNG AND SLEEP

01.2012 - 01.2016

Controlled medical, administrative tasks such as, purchasing, scheduling, payroll, licensure, credentialing, privileging, enrollment, prior authorizations, HIPAA, Fraud, Waste & Abuse Management
I cooperated with medical practitioners to ensure proper maintenance of expirable and certifications
Consistent contact with provider relations and medical staff maintained re-appointments, re-credentialing
Completed enrollments into Medicaid, Medicare and private insurance plans.
I function with departmental heads to evaluate systems and processes to ensure effective medical service
I held responsibility for hiring, training, and conducting performance evaluations of administrative and clinical staff
Trained employees on additional job positions to maintain coverage of roles.
I effectively worked with the medical officer for solving critical issues
Back office duties
Monitored staff performance and addressed issues.
Minimized staff turnover through appropriate selection, orientation and training.
Accomplished financial objectives by forecasting requirements, scheduling expenditures and preparing annual budgets.
Leveraged leadership skills to identify deficiencies and opportunities to improve policies, procedures and controls.
Created training modules and documentation to train staff.
Led team meetings and one-on-one coaching sessions to continuously improve performance.
Enhanced team member performance through use of strategic and tactical approaches, motivational coaching and training.
Maintained adequate staffing to meet objectives within budget.

Medical Assistant

Internal Medicine & Associates

LAS VEGAS, NV

01.2007 - 01.2012

Enthusiastically provided support to the, of the Medical Executive Committee as back office medical assistant
Clinic Manager
Resourcefully helped in daily functions and maintenance of the clinic
Responsibilities included triage, scheduling, check in/out, billing and coding, chart prep
Executed back office duties included injections, phlebotomy, assisted in minor surgeries, IV exchange, and assisted multiple physicians on occasion
Pharmacy calls
Lead several administrative/clinical employees, and scheduled back office monthly meetings, implemented OSHA seminars for doctors.
Performed preliminary physical tests to accurately record results in patient history summary.
Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
Educated patients about medications, procedures and physician's instructions.
Labeled and completed lab requisitions using ICD and CPT coding.
Participated in team meetings to improve workflows and contribute to improving patient population outcomes.
Measured vital signs and took medical histories to prepare patients for examination.

Summary

Overview

Work History

Clinical Operations Manager

Provider Credentialing Consultant

Sr. Contracting & Credentialing Specialist

Lead Credentialing & Privileging Specialist

Privileging Consultant

Private Medical Office Consultant

Credentialing Specialist

Medical Assistant Supervisor

Clinical Administrator/Manager

Medical Assistant

Education

Pending - Biblical Studies

Medical Assisting

High School Diploma -

Skills

Timeline

Similar Profiles

Tarul Kode Tripathi, Pharm.D.Tarul Kode Tripathi, Pharm.D.

Rachel HesterRachel Hester

Abhisheka MoothoosamyAbhisheka Moothoosamy

Mahyara AndradeMahyara Andrade

Danielle M. RobinsonDanielle M. Robinson