Summary
Overview
Work History
Education
Skills
Timeline
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Nohealani Perkins

Goose Creek,SC

Summary

At United Healthcare, I spearheaded the Credentialing and Enrollment team, enhancing operational efficiency and compliance through innovative strategies. My expertise in application processing and analytical thinking led to a significant increase in productivity. Known for exceptional teamwork and problem-solving abilities, I successfully streamlined processes, achieving notable improvements in revenue cycle management and payer relations. Credentialing professional with keen eye for detail and commitment to maintaining high standards. Proven track record in managing credentialing workflows and improving operational efficiency. Emphasizes team collaboration and adaptability to meet dynamic organizational needs. Highly skilled in compliance management and process optimization, with reliable and flexible approach.

Overview

17
17
years of professional experience

Work History

Credentialing and Enrollment Manager

United Healthcare
10.2007 - 05.2024
  • Increased cash flow through timely resolution of payer denials and underpayments.
  • Maintained a thorough understanding of regulatory requirements, ensuring compliance throughout all aspects of the revenue cycle.
  • Managed cross-functional teams to improve overall revenue cycle operations.
  • Established strong relationships with payers, improving communication and resolving disputes more effectively.
  • Conducted regular audits to identify areas for improvement in the revenue cycle process.
  • Streamlined workflows to minimize claim rejections and maximize reimbursement rates from insurance providers.
  • Collaborated with department leaders to develop policies and procedures for maintaining accurate provider records.
  • Led team meetings to discuss progress toward goals, troubleshoot issues, and share best practices among colleagues.
  • Evaluated employee performance and conveyed constructive feedback to improve skills.
  • Ensured accuracy of provider data in internal databases through regular review and updates.
  • Maintained up-to-date knowledge of industry regulations, ensuring ongoing adherence to best practices in provider credentialing.
  • Conducted periodic risk assessments to identify potential vulnerabilities in credentialing workflows and implemented corrective measures as needed.
  • Reduced processing times for credential applications by optimizing workflow efficiency and staff allocation.
  • Enhanced compliance with industry standards by conducting thorough audits of credential files.
  • Demonstrated excellent problem-solving skills in identifying and resolving discrepancies in provider documentation, ensuring compliance with regulatory requirements.
  • Managed the onboarding process for new providers, ensuring timely completion of all required documentation.
  • Streamlined credentialing processes by implementing efficient tracking systems and reducing paperwork.
  • Established strong relationships with external agencies, streamlining communication regarding provider credentials and facility statuses.
  • Set aggressive targets for employees to drive company success and strengthen motivation.
  • Established team priorities, maintained schedules and monitored performance.
  • Developed comprehensive training materials for new team members, ensuring consistent understanding of licensing policies and procedures.
  • Accomplished successful renewal of expiring licenses through meticulous preparation, submission, and follow-up of relevant documentation.
  • Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
  • Reduced processing time for license approvals, implementing standardized procedures and documentation requirements.
  • Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
  • Established performance goals for employees and provided feedback on methods for reaching those milestones.
  • Assisted in organizing and overseeing assignments to drive operational excellence.

Education

GED -

Goose Creek High School
Goose Creek, SC
06-1985

Skills

  • Provider enrollment: Medicare, Medicaid and Commercial Payors
  • Application processing: Paper, Digital to include CAQH
  • Documentation Review
  • Data Management
  • Teamwork and Collaboration
  • Managing Operations and Efficiency
  • Analytical Thinking
  • Conflict Resolution
  • Customer Relationship Management
  • Accreditation Compliance
  • Organizational Skills
  • Problem Resolution

Timeline

Credentialing and Enrollment Manager

United Healthcare
10.2007 - 05.2024

GED -

Goose Creek High School

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Nohealani Perkins