MALISSA POPE
Summary
Results-driven Enrollment Specialist with a proven track record in streamlining credentialing processes and ensuring compliance with state and federal standards. Skilled in managing high-volume workloads, collaborating crossfunctionally, and resolving escalated issues. Known for strong communication skills, attention to detail, and driving process improvements to enhance efficiency and accuracy.
Overview
17
17
years of professional experience
Work History
Enrollment Specialist, Provider Enrollment
Xifin & Radiology Partners
09.2020 - 12.2024
- Managed credentialing efforts for over 150 physicians, ensuring compliance with state and federal standards
- Completed credentialing applications and contracts with health plans
- Worked cross-functionally with departments to meet business goals and handle escalated issues
- Developed recommendations for corrective action and tracked performance trends
Provider Enrollment/Credentialing Coordinator III
Howard University Hospital
09.2018 - 09.2020
- Monitored documentation expiration dates and ensured timely file submissions
- Used CAQH to maintain databases of physician records and credentialing documents
- Assisted with managed care auditing processes and internal file audits
Associate- Anesthesia Verification Specialty/ACC
Emory Healthcare
08.2013 - 09.2018
- Conducted primary source verification of credentials in compliance with regulatory standards
- Prepared credential files for management and committee reviews
- Documented all communications and actions during the credentialing process
Credentialing Specialist I
Health Net Inc. American Health Care
04.2008 - 07.2013
- Completed enrollments into Medicaid, Medicare, and private insurance plans
- Monitored disciplinary actions and corresponded with licensing boards, hospitals, and medical groups to resolve issues
- Assisted in the preparation of file reports and binders for monthly Credentialing Committee meetings
Skills
- CAQH Database System
- Authorization Database for Contract and Referral Provider Information
- Festive/SOURCECORP Scanning Contract In System
- Smart sheet Database
- IntelliApps
- Echo OneApp
- QGneda
- Service Now Database
- Allscripts Database
- NPI System
- Microsoft Office
- Microsoft Word
- Microsoft Excel
- PECOS/CMS Medicare and Medicaid System
Timeline
Enrollment Specialist, Provider Enrollment
Xifin & Radiology Partners
09.2020 - 12.2024
Provider Enrollment/Credentialing Coordinator III
Howard University Hospital
09.2018 - 09.2020
Associate- Anesthesia Verification Specialty/ACC
Emory Healthcare
08.2013 - 09.2018
Credentialing Specialist I
Health Net Inc. American Health Care
04.2008 - 07.2013