Mercedez Varble
Owensboro,KY
Summary
Dynamic healthcare operations and credentialing professional with over 12 years of experience in hospital, physician network, behavioral health, for-profit and nonprofit environments. Expertise in planning and administering comprehensive programs and services, directing credentialing, payer enrollment, and compliance workflows, while developing advanced computerized record systems to enhance efficiency. Trusted cross-functional collaborator dedicated to improving data integrity and reporting, ensuring regulatory compliance with organizations such as the IRS, JCAHO, NCQA, CARF, and state boards. Committed to strengthening stakeholder communication and public relations to foster a culture of transparency and trust within the organization.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Foundation Services Specialist
Owensboro Health Foundation, Inc.
Owensboro, KY
07.2025 - Current
- Delivers operational support and analytical communications to drive strategic goals in philanthropic efforts.
- Administers Raiser's Edge NXT, ensuring accurate data management and effective donor solicitation processes through detailed exports and reporting.
- Achieves streamlined donor management processes through the establishment of effective policies and procedures for cultivation, solicitation, and gift processing. Enhances team capabilities by delivering targeted training on best practices.
- Achieves effective communication with stakeholders through the execution of internal and external plans utilizing donor CRM. Enhances audience engagement by personalizing acknowledgments based on segmentation.
- Conducts in-depth prospect research to enhance donor pipeline through effective implementation of grateful patient tools.
- Assists in gathering data to aid strategic planning assessments and evaluations. Creates dashboards and analyses to support leadership decision-making.
- Achieves IRS compliance for donor gift entries and acknowledgments, enhancing reporting accuracy. Streamlines reconciliation and audit processes in partnership with finance team.
- Analyzes finance and accounting reports; oversees accounts payable/receivable; streamlines processes to improve accuracy and timeliness.
- Oversees communication between volunteer auxiliary and team members to foster collaboration. Manages daily operations to equip team members with essential resources for success. Champions initiatives that improves team performance and engagement.
Provider Enrollment Specialist
Community Health Systems, Inc.
Franklin, TN
11.2021 - 07.2025
- Managed payer enrollment in the state of TX for new providers and practice locations; tracked milestones and maintained complete, accurate provider files.
- Ensured compliance with accreditation standards and regulatory requirements; supported team training, compliance, and project management.
- Maintained and regularly updated provider CAQH records to capture all pertinent elements across databases.
- Prepared initial and re-enrollment application packets (paper and electronic); coordinated re-enrollment dates and deadlines.
- Monitored pending credentialing claim reports; took corrective action to enable timely claims submission and reimbursement.
- Served as primary contact for enrollment matters; communicated with payers, clinics, billing offices, practitioners, IPAs, Managed Care, and Accounts Receivable on status and resolution.
Provider Enrollment & Privileging Specialist
RiverValley Behavioral Health
Owensboro, KY
02.2020 - 11.2021
- Conducted and maintained credentialing and privileging for KY, NM, TX, NC, compiling practitioner data and presenting to Credentials/Executive/Board committees.
- Completed Primary Source Verification and evaluated education, training, and experience for membership and privilege eligibility.
- Performed provider/payer enrollment across multiple states; gathered and submitted payer applications to join networks.
- Ensured compliance with accreditation and regulatory standards, policies, and procedures, including CARF; monitored provider licensure and renewals.
- Verified site-specific program compliance with state boards and licensing requirements.
Medical Staff Specialist (Hospital Privileging)
Owensboro Health Regional Hospital
Owensboro, KY
07.2018 - 02.2020
- Led credentialing/privileging processes; evaluated requests and documentation; facilitated review by department chiefs, Credentials Committee, MEC, and Board.
- Performed Primary Source Verification; investigated and resolved discrepancies from applications and verification sources.
- Maintained credentialing files, databases, reports, minutes, and information systems; analyzed needs of medical staff services.
- Ensured continuous compliance with The Joint Commission, bylaws, and rules/regulations; participated in policy review and updates.
- Coordinated onboarding/orientation training for practitioners; served as facilitator to department chiefs and committee chairs.
- Attended department/committee meetings; prepared minutes and follow-up correspondence on behalf of medical staff leaders.
- Prepared, posted, and maintained specialty call rosters; managed pay-for-call program and daily electronic staff call roster.
Administrative Assistant II (Physician Hospital Organization)
Owensboro Community Health Network
Owensboro, KY
10.2013 - 07.2018
- Assisted Provider Network Specialist with initial credentialing and re-credentialing per NCQA guidelines; maintained accurate provider files.
- Optimized the organization’s fee schedule by benchmarking and adjusting rates to Medicare standards to ensure regulatory alignment and financial accuracy.
- Supported employer health fairs and marketing at community events; strengthened stakeholder relationships.
- Recorded meeting minutes; scheduled and coordinated meetings, conferences, appointments, special events, and catering.
- Processed access fees, administration fees, and miscellaneous revenue checks for monthly deposit; maintained records with strong attention to detail.
- Served as purchasing agent for the department (requisitions, equipment inventory, recordkeeping) within budget guidelines; completed data entry and general office duties.
Education
Bachelor of Science - Organizational Leadership - Healthcare Leadership
University of Louisville
Louisville, KY08-2026
Skills
- Data & Information Systems: Raiser’s Edge NXT; credentialing/privileging databases (Verity CredentialStream, MDStaff); CAQH; CRM segmentation; data integrity management; queries, lists, exports, and reporting
- Credentialing & Enrollment Systems: Primary Source Verification; payer enrollment platforms; provider file management; licensure and accreditation monitoring
- Compliance & Regulatory: TJC, NCQA, CARF, CMS, state guidelines, IRS gift processing standards; policy and procedure development; audit support
- Financial & Operational Tools: Accounts payable/receivable processing; fee schedule benchmarking; finance and accounting report analysis
- Productivity & Documentation: Microsoft Excel, Word, PowerPoint, Outlook; dashboard creation; committee materials; meeting minutes; workflow documentation
- Research & Communications Tools: Prospect research platforms; CRM‑based communication workflows; donor acknowledgment systems; public relations support tools
Affiliations
- Board of Directors Member — Theatre Workshop of Owensboro (2022–Present)
- Secretary — Kentucky Association of Medical Staff Services
- Volunteer — Theatre Workshop of Owensboro (2012–Present)
- Chair – Unit Performance Improvement Committee, Owensboro Health Business Office (2013–2018)
Certification
- Certified Provider Credentialing Specialist - October 2020 - Present
- Certified Provider Enrollment Specialist - March 2022 - Present
Timeline
Foundation Services Specialist
Owensboro Health Foundation, Inc.
07.2025 - Current
Provider Enrollment Specialist
Community Health Systems, Inc.
11.2021 - 07.2025
Provider Enrollment & Privileging Specialist
RiverValley Behavioral Health
02.2020 - 11.2021
Medical Staff Specialist (Hospital Privileging)
Owensboro Health Regional Hospital
07.2018 - 02.2020
Administrative Assistant II (Physician Hospital Organization)
Owensboro Community Health Network
10.2013 - 07.2018
Bachelor of Science - Organizational Leadership - Healthcare Leadership
University of Louisville
Core Leadership & Management Highlights
- Program administration: developed and maintained policies, procedures, and cross-functional workflows for donor management, credentialing, and payer enrollment.
- Compliance & quality: ensured adherence to IRS gift processing, The Joint Commission (JCAHO), NCQA, CARF, CMS, and state board requirements; supported audits and committee reviews.
- Fiscal operations: analyzed finance and accounting reports; oversaw AP/AR; optimized fee schedules by benchmarking rates to Medicare standards.
- Data & systems: administered Raiser’s Edge NXT and credentialing databases; maintained CAQH; strengthened reporting for planning, evaluation, and decision-making.
- People leadership: liaised with volunteer auxiliary; supported training and onboarding; coordinated with payers, providers, clinics, IPAs, managed care, and revenue cycle.
- Communications: executed internal/external communication plans; prepared board/committee materials and meeting minutes; supported public relations and community engagement.