Lisa Benson
Covington,GA
Summary
Efficient Provider Enrollment Specialist known for high productivity and ability to complete tasks swiftly. Specialized in navigating complex healthcare systems, understanding regulatory compliance, and managing provider data with accuracy. Excel in communication, problem-solving, and time management, ensuring smooth enrollment processes and maintaining strong relationships with providers.
Efficient professional in government program administration, known for high productivity and ability to complete tasks swiftly. Specialize in eligibility determination, case management, and regulatory compliance. Excel in communication, problem-solving, and adaptability, ensuring smooth operations and client satisfaction.
Assertive Provider Enrollment Specialist proudly offering many years of managing credentialing for government payor applications. Structured and business-minded professional known for analyzing reports for physician enrollment. Detail-oriented and smart with great decision-making skills.
Responsible, communicative, and dedicated to accurately and efficiently processing enrollment applications. Specialties include data entry, customer service, and promoting company initiatives.
Overview
9
9
years of professional experience
Work History
Senior Provider Enrollment Specialist
Envision Physicians Services
Fort Lauderdale , Florida
07.2022 - Current
- Provided guidance to providers on the enrollment process, timelines, and requirements.
- Conducted interviews with applicants, explaining benefits process, and which programs were available.
- Kept watchful eye on physician expiration dates and contacted practitioners to inform when such dates were near.
- Processed re-enrollment requests for terminated providers who wish to be reinstated into the network.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Reconciled differences between submitted documentation and information received from providers against government databases.
- Prepared weekly summaries detailing newly enrolled providers, pending applications, rejected applications.
- Collaborated with internal departments to ensure proper processing of enrollment applications.
- Reviewed and updated provider enrollment applications to ensure accuracy and completeness of information.
- Conducted audits of existing providers' records to verify continued eligibility for participation in network programs.
- Prepared reports on enrollment statistics and discussed how to improve enrollment procedures during team meetings.
- Responded to requests for information about enrollment process.
- Analyzed changes in rules and regulations related to provider enrollment and communicated relevant updates to team members.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Monitored daily workflow activity related to provider enrollments and identified areas for improvement.
- Followed up with insurance carriers to address and rectify denied claims.
- Responded promptly to inquiries from providers regarding their status within the network.
Birth Registrar
Parallon Workforce Solutions
Snellville , Georgia
12.2015 - 04.2021
- Provided guidance to parents regarding the completion of birth registration forms.
- Registered patients for diagnostic appointments, surgeries and medical consultations using electronic health record system.
- Attended meetings with community organizations to discuss issues relating to vital record keeping requirements and procedures.
- Collected, evaluated and stored documents securely in permanent records.
- Reviewed and verified patient information to ensure accuracy of birth records.
- Gathered data from medical staff and other sources to complete birth certificates.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Monitored compliance with applicable laws, regulations, policies and procedures related to vital records management.
- Provided customer service support by answering questions or providing advice about obtaining certified copies of vital records.
- Managed the daily operations of a central registry office including responding to inquiries from customers both in person or via telephone or email.
Education
Associate of Applied Science - Medical Terminology- Health Info- Medical Records
DeVry University
Decatur, Georgia 08-2017
Skills
- Continuous learning attitude
- Healthcare
- Ethical conduct standards
- Physician enrollment
- Practitioner enrollment
- Strong communication skills
- Medical terminology
- Relationship building
- Data entry proficiency
- Effective written and verbal communication
- Credentialing
- Performance monitoring
- Goal setting
- Reporting and file reviews
- HIPAA compliance awareness
- Credentialing data coordination
- Insurance verification experience
- Re-credentialing request follow up
- Validation of discrepancies
Timeline
Senior Provider Enrollment Specialist
Envision Physicians Services
07.2022 - Current
Birth Registrar
Parallon Workforce Solutions
12.2015 - 04.2021
Associate of Applied Science - Medical Terminology- Health Info- Medical Records
DeVry University