Shauna Hughes
North Bangor
Summary
Provider enrollment specialist with strong expertise in credentialing and compliance management. Proven track record of streamlining enrollment processes while ensuring strict adherence to healthcare regulations. Demonstrated ability to enhance operational efficiency and maintain high standards of compliance.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Provider Enrollment Specialist
Public Consulting Group, Inc.
Albany
06.2023 - 01.2026
- Processed provider enrollment applications for healthcare services, ensuring timely and accurate completion.
- Verified provider credentials to ensure compliance with state regulations.
- Coordinated communication between providers and regulatory agencies, facilitating compliance and resolution of inquiries.
- Maintained accurate records in the enrollment management system diligently.
- Assisted in training new team members on enrollment procedures and guidelines.
- Resolved provider inquiries regarding enrollment status promptly and professionally.
- Reviewed policy updates to ensure adherence to changing healthcare regulations.
- Supported members through navigation of enrollment process to facilitate optimal decisions.
- Responded to requests for information about enrollment process.
- Created detailed reports outlining updates made to provider profiles as well as any issues or errors encountered during processing activities.
- Performed verification checks for new provider enrollments in accordance with company policies and procedures.
- Assisted providers in completing application packages, ensuring all required documents were obtained to streamline the enrollment process.
- Evaluated incoming requests for exceptions or waivers from standard policy guidelines.
Practice Manager
Banfield Animal Hospital
Norwalk
08.2018 - 04.2023
- Managed daily operations for a busy veterinary practice.
- Coordinated staff schedules to ensure adequate coverage and efficiency.
- Oversaw inventory management and ordering of medical supplies.
- Trained and mentored team members on best practices in animal care.
- Facilitated client communication to enhance service quality and satisfaction.
- Implemented new procedures to improve workflow within the clinic.
- Conducted performance evaluations to support employee development initiatives.
- Maintained compliance with veterinary regulations and hospital policies.
- Resolved escalated customer service issues in a timely manner while maintaining a high level of professionalism.
- Managed vendor relationships for supplies and services related to the practice.
- Directed day-to-day practice operations, coordinating front desk reception, appointment scheduling, billing and coding, and insurance verification.
- Conducted regular meetings with staff to discuss operational issues and ensure proper communication between departments.
- Managed financial records, ensuring accuracy in billing and accounts receivable and payable.
- Supported entire practice's staff, which boosted efficiency and improved overall process flow.
- Communicated with patients with compassion while keeping medical information private.
- Complied with OSHA and HIPAA regulations.
- Provided leadership and guidance to the medical team in order to meet goals and objectives.
- Facilitated implementation of new technology systems into existing workflows in order to improve operational efficiency.
- Motivated staff by offering direction and providing constructive feedback.
- Coordinated staff recruitment, training, and scheduling activities.
- Assessed medical office operations, identified areas of improvement, and developed plans for corrective action.
- Created and implemented policies and procedures for effective practice management.
- Participated in strategic planning initiatives aimed at developing long-term goals for the practice's growth and success.
- Developed reports tracking key performance indicators to inform practice management decisions.
- Mentored and coached interns and newly hired team members on office procedures and computer systems.
- Analyzed data from various sources to identify trends or opportunities for improvement within the practice.
- Explained policies, procedures and services to patients.
- Recruited, hired and trained new medical and facility staff.
Lead Front Desk Receptionist
Rippowam Animal HospitalPC
Stamford
03.2010 - 06.2018
- Managed front desk operations and ensured smooth patient check-in processes.
- Coordinated appointment and surgery scheduling for veterinary staff to optimize clinic operations.
- Assisted clients with inquiries and provided exceptional customer service support.
- Maintained accurate patient records and updated information in the database.
- Managed billing procedures and ensured accurate payment processing at front desk to enhance financial transactions.
- Trained new receptionists on office protocols and customer interaction techniques.
- Provided assistance with onboarding new employees by providing orientation materials and explaining company policies.
- Welcomed guests at reception, ensuring a friendly atmosphere.
- Acted as liaison between customers and internal personnel to ensure customer satisfaction.
- Established communication protocols for front desk operations to streamline workflow and improve service delivery.
- Maintained an organized front desk by organizing daily paperwork, scheduling appointments and managing incoming calls.
- Utilized problem solving skills to resolve customer issues quickly and effectively.
Education
High School Diploma -
Torrington Highschool
Torrington, CT06-1996
Skills
- Provider enrollment and credentialing
- Eligibility verification
- Compliance management
- Healthcare operations
- Data administration
Certification
Certified Nurses Aid
Timeline
Provider Enrollment Specialist
Public Consulting Group, Inc.
06.2023 - 01.2026
Practice Manager
Banfield Animal Hospital
08.2018 - 04.2023
Lead Front Desk Receptionist
Rippowam Animal HospitalPC
03.2010 - 06.2018
High School Diploma -
Torrington Highschool