Mirtha Baez
Sunrise,USA
Summary
Highly accomplished Medical Practice Administrator with extensive experience in healthcare operations, financial management, revenue cycle management, denial management, billing, and office administration, complemented by over 15 years of focus on patient care coordination and workflow optimization. Proven track record in provider credentialing, allied health professional compliance oversight, and bilingual fluency in English and Spanish; a dedicated and meticulous professional seeking to join a team-driven organization committed to high-quality customer care.
Overview
15
15
years of professional experience
Work History
Credentialing Coordinator I (Remote)
Envision Physician Services
FT. Lauderdale, FL
10.2021 - Current
- Managed provider credentialing across multiple facilities, ensuring compliance with licensing and certification requirements.
- Processed over 100 expirables monthly, maintaining accuracy in provider profiles and credentialing databases.
- Conducted primary source verifications, background checks, and analyzed privileging criteria for medical and allied health professionals.
- Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
- Managed end-to-end provider credentialing process, ensuring compliance with industry standards.
- Developed effective communication strategies between providers, staff, and management.
- Collaborated with hospital staff, department chairs, and external credentialing offices to streamline workflows.
- Trained junior staff in credentialing procedures and compliance standards.
Medical Billing and Denial Specialist
Regenesis Community Health Center
Spartanburg, SC
09.2018 - 02.2019
- Planned and implemented billing and reimbursement systems tailored to payer-specific requirements.
- Acted as subject matter expert in revenue cycle management; analyzed denial trends and developed solutions that reduced rejections and improved collections.
- Led projects with payer reps to resolve denial trends, improved claim processes, and enhanced patient revenue cycle experience.
- Created performance reports and identified areas for billing optimization.
Medical Staff Project Credentialing Coordinator
Physicians Regional Medical Center
Naples, FL
04.2016 - 08.2018
- Maintained detailed credentialing records and compliance documentation for medical and allied health staff.
- Coordinated initial and recredentialing processes, verified employment history, education, and peer references.
- Supported OPPE/FPPE processes, reviewed applications, and ensured timely recredentialing, and documentation accuracy.
- Ensured adherence to Medical Staff Bylaws, responded to credentialing verifications, and updated EMRs and credentialing systems.
- Collaborated across departments to facilitate outreach, telemedicine credentialing, and privileging activities.
- Upheld strict confidentiality and ensured that providers met eligibility standards across all facilities.
Medical Practice Administrator & Billing Manager
Cardiology Consultants of Naples, LLC
Naples, FL
02.2011 - 04.2016
- Oversaw operations for a high-volume interventional cardiology clinic, managing staff, scheduling, billing, and patient care coordination.
- Provided customer-focused service to 120+ patients daily, maintaining satisfaction ratings of 4.1/5 stars.
- Recruited, trained, and supervised clinical and administrative staff; facilitated cross-functional communication and conflict resolution.
- Managed the full revenue cycle, leveraging AdvancedMD and Trizetto to reduce claim denials by 24% and A/R backlog by 42%.
- Oversaw diagnostic scheduling, surgical pre-authorizations, and patient education, ensuring compliance and continuity of care.
- Addressed patient billing concerns, streamlined insurance verification, and maintained accurate provider credentialing files.
- Participated in quality initiatives, managed vendor relationships, and generated operational reports for leadership.
Education
AS Degree - Computer Networking Engineer
Florida Career College
Miami, FL04.2004
Diploma Program - Computer Repair Technician
Florida Computer and Business School
Miami, FL04.2003
Skills
Leadership, Communication Management, Time Management, Problem-Solving, Collaboration and Accountability, Adaptability and Flexibility, Customer Service Skills, Data Management, Detail-Oriented, Remote Collaboration Skills
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Timeline
Credentialing Coordinator I (Remote)
Envision Physician Services
10.2021 - Current
Medical Billing and Denial Specialist
Regenesis Community Health Center
09.2018 - 02.2019
Medical Staff Project Credentialing Coordinator
Physicians Regional Medical Center
04.2016 - 08.2018
Medical Practice Administrator & Billing Manager
Cardiology Consultants of Naples, LLC
02.2011 - 04.2016
AS Degree - Computer Networking Engineer
Florida Career College
Diploma Program - Computer Repair Technician
Florida Computer and Business School
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