Summary
Overview
Work History
Education
Skills
Timeline
Generic

Michelle Teart

Tenino,WA

Summary

Highly motivated Credentialing Specialist. I have a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the company.

Overview

7
7
years of professional experience

Work History

Credentialing Specialist and Billing Manager

Comprehensive Care Services
Plymouth, MI
01.2021 - 01.2024
  • Developed and implemented billing procedures to ensure accurate data entry and timely payment collection.
  • Participated in process improvement initiatives to increase efficiency within the department.
  • Set up and maintained Tebra electronic billing system.
  • Created and updated financial reports on frequent basis to present information to leadership teams.
  • Completed enrollments into Medicaid, Medicare and private insurance plans.
  • Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
  • Scheduled or conducted new employee orientations.
  • Familiarity with working the entire contracting process from start to finish.
  • Submitted initial and re-credentialing enrollment applications for Medicaid, Medicare and commercial insurance.
  • Responsible for the accuracy of supporting documentation for contracts and completing documents accurately.
  • Enrolled medical providers and groups in both in and out of network commerical insurance plans.
  • Maintained and updated organizational charts, employee handbooks or performance evaluation forms.
  • Ensured timely completion of credentialing processes by providing guidance to providers on required documentation.
  • Selected qualified job applicants or referred to managers to make hiring recommendations.
  • Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.

Credentialing Specialist and Human Resource Admin

Northwest Monitoring
Gig Harbor, WA
11.2018 - 12.2020
  • Oversaw the benefits enrollment process by answering questions and assisting employees with details.
  • Managed payroll for over 33 hourly and salaried employees.
  • Kept operations in compliance with requirements by applying knowledge of applicable regulations, legal statutes and tax code information.
  • Calculated overtime, vacation sick hours and other categories of time.
  • Applied comprehensive understanding of HR principles and employment laws and regulations to provide counseling to and develop policies.
  • Managed recurring HR processes such as onboarding new staff.
  • Developed process improvements and streamlined procedures to effectively resolve employee discrepancies.
  • Created job descriptions to attract targeted talent pool within market wage range.
  • Discussed medical, dental, short-term and long-term benefit plans with new hires and eligible employees with status changes.
  • Conducted new hire orientations making new employees feel welcome and ready to succeed.
  • Set up NPI numbers for providers and facilities and updated current profile information.
  • Developed reports related to provider demographic information, status changes, verifications completed, as requested by management or external customers.
  • Completed enrollments into Medicaid, Medicare and private insurance plans.
  • Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
  • Prepared or maintained employment records using human resources management system software.
  • Processed re-credentialing applications for existing providers according to contractual requirements.

Provider Service Coordinator

Deer Oaks Mental Health Associates
San Antonio, TX
10.2016 - 08.2018
  • Answered questions and responded to inquiries to deliver high level of service to mental health providers.
  • Completed various reports and analyzed each report to decide where improvements could be made.
  • Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
  • Sought clarification from physicians for answers to any needed coding interpretations prior to abstracting records.
  • Reviewed all claims for accurateness and appropriateness.
  • Verified final claim submissions by comparing account charges with documentation.
  • Reviewed medical records to meet insurance company requirements.
  • Maintained accurate and timely charge submissions utilizing electronic charge capture practices, including billing and account receivables (BAR) system and medical billing clearinghouse accounts.
  • Applied HIPAA Privacy and Security Regulations while handling patient information.

Education

Master of Arts - Developmental Psychology

Liberty University
Lynchburg, VA
06-2016

Bachelor of Arts - Developmental Psychology

University of Washington
Tacoma, WA
06-2004

Skills

  • Staff Management
  • Process Improvement
  • Project Planning
  • Policy Administration
  • Research, interpret, and clarify rules, regulations, and policies
  • Knowledge of CAQH, PECOS and NPPES websites
  • Able to self-direct and work independently
  • Exceptional organizational skills
  • Excellent ability to pay close attention to detail and multi-task
  • Performance Evaluations
  • Employee Coaching and Mentoring
  • MS Office
  • Provide creative, responsive, high-quality technical advice and consultation

Timeline

Credentialing Specialist and Billing Manager

Comprehensive Care Services
01.2021 - 01.2024

Credentialing Specialist and Human Resource Admin

Northwest Monitoring
11.2018 - 12.2020

Provider Service Coordinator

Deer Oaks Mental Health Associates
10.2016 - 08.2018

Master of Arts - Developmental Psychology

Liberty University

Bachelor of Arts - Developmental Psychology

University of Washington

Similar Profiles

CREATE PROFILE
Michelle Teart