Michael Matt

-Manage credentialing process for 8000 plus applicants/providers ensuring alignment with privileges sought.

• Review provider applications for completeness and compliance with Joint Commission Standards as well as hospital system's rules, regulations and by-laws
• Prepare applications for credentials committee meetings.
• Address provider inquires regarding system access and operational tools.
• Coordinate agendas and minutes for departmental meetings, adhering to established standards.

-Manage credentialing and insurance enrollment for 5000 plus providers.

• Assist providers with applications and revalidation requests.
• Complete primary source verification and maintain compliance with AAAHC, NCQA and Joint Commission Standards.
• Review manged care contracts using Sharepoint, Salesforce, and other reporting systems.
• Develop monthly and quarterly analytical reports to inform decision making
• Update credentialing databases ( CAQH, PECOS, NPPES Registry Sharepoint, et al.

-Manage credentialing and re-credentialing for 175 plus providers across 13 sites.

• Assist providers with applications and document completion.
• Enroll providers in government an commercial insurances.
• Conduct primary source verification and maintain accurate provider records.
• Develop analytical reports and update credentialing databases.
• Ensure compliance with AAHC, NCQA, and Joint Commission Standards.

-Manage credentialing for 320 plus providers nationwide.

• Process enrollment and re-credentialing for manged care, government and commercial insurance carriers.
• Perform primary source verification using state and national resources.
• Develop and implement credentialing policies and procedures.
• Maintain accurate credentials files and respond to inquires.

-Manage credentialing for 120 physicians nationally, ensuring compliance with AAAHC and NCQA Standards.

• Process enrollment and re-credentialing for government and commercial insurance carriers.
• Conduct primary source verification using sate and national resources.
• Develop and implement credentialing policies and procedures.
• Maintain strong relationships with physicians and provider relations at payers.

-Processed provider enrollment and re-credentialing for 100 plus clinical staff at 10 offices with insurance carriers

• Maintain accounts receivables for 30 million dollar not for profit organization reducing over 90 day receivables to below 10 percent.
• Develop analytical reports summarizing credentialing activities and policies.
• Foster relationships with providers and all insurance carriers.