MARSHA M. DIY
1729 Wycliffe, Irvine,USA
Summary
- Results-focus onboarding providers with proven track record in streamlining onboarding processes.
- Known for collaborative approach and ability to adapt to changing needs, ensuring smooth transitions for new and existing providers.
- Detail-oriented individual that is skilled in effective communication and teamwork, contributing to team success and high employee satisfaction.
- Track record of fostering positive relationships, not just to the providers, but to every individual and team that I work with.
- Reliable and dedicated to utilizing the organization's best practices.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Provider Onboarding Specialist – Internal Providers
MEMORIALCARE MEDICAL FOUNDATION
01.2014 - Current
- Responsible for the successful onboarding of all new internal providers which includes but is not limited to Medi-Cal and Medicare applications, hospital privileges, obtaining credentialing paperwork confirming health plans enrollment;
- Initiate the onboarding process to newly recruited MCMG internal providers—employed, non-employed and Independent Contractors;
- Work and collaborate with the Centralized Verification Office (CVO), MHS Medical Staff Office team and MCMG Credentialing Coordinators and Contracting for the provider’s credentialing status;
- Communicate and work with the upcoming providers thoroughly to streamline the onboarding process and ensure that all the appropriate licensures and supporting documents available
- Maintain provider’s confidentiality, and provide effective communication and professional interaction with the providers, facility managers, billing team, medical staff office team and other inter-department individuals;
- Collaborate with the Physician Recruitment Team, Clinical Operation Team and Senior Medical Directors to establish and reach the target goals and provide updates throughout the onboarding process;
- Utilize skills set to accurately complete Medicare, Medi-Cal and other government-related provider enrollment—either initial and revalidation applicationsfor internal providers;
- Complete and maintain the Medicare and Medi-Cal enrollment records for the MCMG clinics;
- Independently research and resolve provider’s enrollment questions;
- Primary liaison and first line of contact for our internal providers, facility managers, inter-department staff members and MHS Medical Staff Office team in relation to credentialing, licensing and other issues and requests;
- Assist/Redirect MCMG internal providers, facility managers, MHS Medical Staff Office team, billings, internal and external individuals to resolve issues and any other requests with excellent customer service;
- Communicate all new providers to necessary teams in order to have providers added to Epic system, roster and health plans;
- Work with key stakeholders at all levels of the organization on various projects, and provide support and resources as requested;
- Maintain onboarding files and data in the credentialing system, Echo;
- Submit reimbursement requests for the employed providers license application fees and renewals—both medical license and DEA certification;
- Support Credentialing team for completing the provider’s credentialing application with other IPAs or hospital privileges applications;
- Maintain a good rapport with various teams and individuals in all aspects.
- Facilitated onboarding processes for new hires, ensuring compliance with organizational policies.
- Collaborated with cross-functional teams to integrate feedback into onboarding practices and improve overall experience.
- Worked closely with new hires, answering questions and addressing various concerns during onboarding process.
- Managed multiple onboarding projects simultaneously, ensuring timely completion while maintaining high-quality standards.
Provider Relations Representative – North County
MEMORIALCARE MEDICAL FOUNDATION
04.2012 - 12.2013
- Provided in-service presentations and support to new and existing external contracted providers;
- Trained external providers on EPIC Tapestry in order to request for referral authorizations, verify and review claims and billings;
- Processed Medicare, Medi-Cal, CalOptima Direct and Other Government-Related provider enrollment applications—both initial and revalidationfor MCMG internal providers;
- Practiced excellent customer service to internal and external clients.
Accounts Payable Coordinator
MEMORIALCARE MEDICAL FOUNDATION
03.2006 - 04.2012
- Processed payments for all invoices from vendors and inter-departments;
- Applied payments to its designated general ledger accounts;
- Maintained excellent customer service to vendors for a smooth working relationship;
- Processed stop payments and re-issue checks when requested;
- Reconciled balance accounts with vendors on a monthly basis to streamline the processing method;
- Mailed out payments to the vendors in a timely manner.
Insurance Eligibility Coordinator
MEMORIALCARE MEDICAL FOUNDATION
09.2001 - 03.2006
- Verified insurance coverages and benefits of the medical group’s members for eligibility;
- Provided excellent customer service to patients and insurance companies.
Education
Bachelor of Science in Commerce - Data Processing
UNIVERSITY OF ST. LA SALLE
01.1993
Skills
- Performance tracking
- Cross-functional coordination
- Onboarding
- Relationship building
- Microsoft office
- Remote conferencing and communication
- Data analysis
- Adaptability and Flexibility
- Active Listening
- Teamwork
Certification
- ICD-10-CM Proficiency Certification December 11/2015 American Academy of Professional Coders
- Medical Coding Course January – June 2010 The Coding Source
- QuickBooks 1 January – June 2005 Regional Occupational Program (ROP)
- Introduction to Medical Management and Billing August 2002 – January 2003 Coastline ROP
- Medical Terminology of Human Anatomy August 2002 – January 2003 Coastline ROP
- Computerized General Accounting 1 & 2 February – June 2000 Central County ROP
- Certified Professional Coder Certification Issued on July 2010 American Academy of Professional Coders
- Life Insurance Agent Issued on December 31, 2006 Life and Health Insurance State License California Department of Insurance
Timeline
Provider Onboarding Specialist – Internal Providers
MEMORIALCARE MEDICAL FOUNDATION
01.2014 - Current
Provider Relations Representative – North County
MEMORIALCARE MEDICAL FOUNDATION
04.2012 - 12.2013
Accounts Payable Coordinator
MEMORIALCARE MEDICAL FOUNDATION
03.2006 - 04.2012
Insurance Eligibility Coordinator
MEMORIALCARE MEDICAL FOUNDATION
09.2001 - 03.2006
Bachelor of Science in Commerce - Data Processing
UNIVERSITY OF ST. LA SALLE
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