LAURIE BOSTON
Rollinsford
Summary
Diligent Associate Specialist, Corporate Credentialing-Remote with comprehensive background in provider enrollment processes. Demonstrated ability to streamline enrollment procedures, ensuring timely and accurate credentialing. Proven expertise in managing documentation and compliance, displaying exceptional attention to detail and communication skills.
Overview
21
21
years of professional experience
Work History
Provider Enrollment Specialist
Wentworth-Douglass Hospital (part of Mass General Brigham Hospital)
04.2005 - 03.2025
- Resolved complex enrollment discrepancies across multiple platforms (Availity, NPPES, PECOS, Tricare, Medicaid and Medicaid product line, and other commercial plans) to ensure provider activation and billing readiness.
- Maintained CAQH profiles, prepared and submitted required documentation. Re-attested every 90 - 120 days.
- Coordinated provider onboarding and credentialing for diverse specialties, including RD, NP PhD, PsyD, LCSW, LMFT, LPC, LMHC, PT, OT, SLP, PCP, MD, Radiology, Dental.
- Strengthening the link between provider credentialing and the revenue cycle, reducing claim denials and enhancing collections.
- Developed, updated, and delivered staff training programs on evolving payer policies, compliance standards, and operational best practices.
- Maintained databases and credentialing records to support audit readiness and payer revalidation processes.
- Maintain relationships with individual contacts for the government agency and commercial insurance providers.
- Remote
Enrollment Coordinator, and Enrollment Group
Mass General Brigham/Wentworth-Douglass Hospital (Part of Mass General Brigham)
04.2005 - 03.2025
- Acted as the primary liaison with third-party enrollment vendors, streamlining communications to enhance operational effectiveness.
- Remote
Medical Billing Specialist
Wentworth Douglass Hospital
Dover, NH
04.2004 - 03.2025
- Coordinated with cross-functional teams for seamless integration of new providers into existing systems.
- Collaborated closely with billing departments to ensure accurate invoices based on verified provider credentials and services rendered.
- Managed multiple priorities under tight deadlines, ensuring timely completion of tasks without sacrificing quality.
- Fostered a positive and collaborative work environment, contributing to team success and increased job satisfaction.
- Maintained comprehensive records of enrolled providers, enabling easy access to information for internal stakeholders.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled
- Rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Identified and resolved patient billing and payment issues. Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Verified insurance of patients to determine eligibility.
- Verified accuracy of accounts payable payments, resulting in 30% reduction in payment errors and check reissues.
Education
GED -
York County Technical College
Wells, MESkills
- Strong communication skills
- HIPAA compliance awareness
- Effective written and verbal communication
- Regulatory requirements
- Health care industry
- NCQA Standards
- MD Staff-Medisoft-Therapist Helper
- Written and verbal communication
- Critical thinking
- Confidentiality
Timeline
Provider Enrollment Specialist
Wentworth-Douglass Hospital (part of Mass General Brigham Hospital)
04.2005 - 03.2025
Enrollment Coordinator, and Enrollment Group
Mass General Brigham/Wentworth-Douglass Hospital (Part of Mass General Brigham)
04.2005 - 03.2025
Medical Billing Specialist
Wentworth Douglass Hospital
04.2004 - 03.2025
GED -
York County Technical College