Stacie Kang
Chelsea,AL
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Self motivated Individual offering a concrete background in Healthcare Administration. Great leadership abilities and dynamic team performer. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
13
13
years of professional experience
Work History
Provider Credentialing Specialist
Strategic Staffing Solutions - BCBS Of Louisiana
Baton Rouge, LA
03.2022 - Current
- Conducted primary source verifications such as background checks and board certifications.
- Received and evaluated applications to look for missing and inaccurate information.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Compile appropriate information to make requested credentialing, contractual, and demographic updates and changes related to provider
- Compile data into systems of record in an accurate, complete and timely manner.
- Manage and sustain positive provider relationships.
- Setup providers and networks in systems of record, assign provider numbers and communicate with provider community.
- Facilitate accurate financial claims payment and provider directory processes. Represent BCBSLA to external provider communities and internal stakeholder groups.
Credentialing Analyst
Insight Global, LLC - BCBS Of Alabama
Birmingham, AL
06.2021 - 12.2021
- Conducted primary source verifications such as background checks and board certifications
- Obtained NPI numbers for providers and facilities and updated existing profiles
- Enrolled providers and Medicaid, Medicare and private insurance plans
- Collected and analyzed information to monitor compliance outcomes and identify and address trends of non-compliant behavior
- Responsible for maintaining and adding current and accurate data for all providers
- Completes provider licensing applications and state renewal applications as needed
- Completes providers credentialing and re-credentialing applications and monitors and follows up as needed and documents progress on daily basis.
- Received and evaluated applications to look for missing and inaccurate information
Provider Relations Advocate
UnitedHealth Group
Birmingham, AL
01.2020 - 02.2021
- Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on-site enrollment opportunities
- Managed provider relations mailbox by triaging inquiries, facilitating resolution of incoming requests and forwarding requests to appropriate parties
- Assisted with physician recruitment by identifying specific providers within designated territories, negotiating rates for new physicians and distributing provider agreements, successfully recruiting 50 new physicians per year
- Identified network gaps and collaborated with senior manager to fill deficiencies
- Gathered, organized and input information into digital database
- Helped implement training and development of external providers through education programs
- Initiated physician and hospital orientations to support ongoing education of health care provider community
- Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on-site enrollment opportunities
Network Development Coordinator
SPNet Clinical Solutions/ SPNet Medical, Inc
Birmingham, AL
10.2016 - 01.2020
- Partnered with business teams and IT personnel to align project goals with business strategy and define project milestones
- Defined and integrated roles, responsibilities and processes for business team and data management organization
- Evaluated success of training programs and recommended improvements to upper management to enhance effectiveness
- Managed new employee orientation training process for more than 10 employees each year
- Negotiate single case agreements and rates with providers as directed by management
- Provide assistance to Director of Contracting to work to establish long term contracts with network facilities for new providers that are obtained by the company
- Response to providers inquiries and or complaints to ensure open communication and prompt resolution of provider issues
- Research potential network participants to assist with development of state, regional, and national networks as directed
- Maintain internal and provider data integrity including provider databases
- Assist with provider education to ensure smooth transition into the network.
Contracts Coordinator
Magnolia Health
Jackson, MS
07.2013 - 08.2016
- Monitored all incoming contracts and service agreements for correct pricing and information
- Coordinated and attended meetings as company's main contact to review contractual obligations
- Interface with credentialing staff to ensure data and systems are in sync
- Provide support to contract negotiators to ensure successful completion of the contracting process
- Managing existing contracts while seeking additional entities to expand company profits
- Organize and maintain provider databases for contractors
- Maintain spreadsheets and databases; collect, tract, prepare, and compile data for daily reports
- Creates contracts and manages the contracting process unitizing the Emptoris Contract Management System to ensure that the new business contract deadlines are met
- Review final contracts before they are sent out to each provider that joins within the network
- Obtained documents, clearances, certificates, and approvals from local state, and federal agencies
- Offered friendly and efficient service to customers, handled challenging situations with ease
- Maintained energy and enthusiasm in fast-paced environment.
Management Analyst
NaphCare, Inc
Birmingham, AL
01.2011 - 03.2013
- Verified submitted documents for completeness and compliance with company policies, addressing discrepancies and collaborating to troubleshoot where necessary
- Worked with internal and external parties to maximize value of assigned contracts in company portfolio
- Worked collaboratively with administrative staff in negotiation, correspondence, documentation and compliance checks for service contracts
- Developed and followed processes to manage contracts and remain in compliance with company commitments and regulatory obligations
- Developed comprehensive medical service contracts with hospital, surgery centers, long-term care facilities, physicians, ect
- For inpatient, outpatient, and onsite services for Federal Correctional Facilities
- Negotiate competitive reimbursement Medicare/Medicaid rates with hospitals and specialists to meet cost containment needs
- Process claims at negotiated rates to fulfill cost containment needs, for the Federal Prisons we maintain
- Maintain positive, professional relationships with current participating providers
- Gathered, documented and modeled data to assess business trends.
Front Office Manager
Lemak Sports Medicine
Birmingham, AL
10.2007 - 07.2010
- Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel
- Held oversight of office inventory activities, including ordering and requisitions, stocking and shipment receiving
- Managed files and records for clients and adhered to safety procedures to prevent breaches and data misuse
- Prepared reports to assist business leaders with key decision making and strategic operational planning
- Responsible to oversee the front office staff at all times within the clinic
- Supervised, trained, and guided new employees and responded quickly to questions to improve understanding of job responsibilities
- Communicated corporate objectives across divisions through regular correspondence and scheduled status updates
- Managing incoming and outgoing correspondence and physicians schedules
- Organized details of special events, travel arrangements, and agendas
- Supported management and staff and assisted with major projects.
Education
Bachelor of Science - Health Services Administration
University of Alabama At Birmingham
Birmingham, AL 08.2022 - 12.2008
Associate of Applied Science - Applied Science
Bevill State Community College
Sumiton, AL 08.1997 - 05.1999
Skills
Excellent Communicationundefined
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
Opportunities Don't happen.You create them.
Chris Grosser
Timeline
Bachelor of Science - Health Services Administration
University of Alabama At Birmingham
08.2022 - 12.2008
Provider Credentialing Specialist
Strategic Staffing Solutions - BCBS Of Louisiana
03.2022 - Current
Credentialing Analyst
Insight Global, LLC - BCBS Of Alabama
06.2021 - 12.2021
Provider Relations Advocate
UnitedHealth Group
01.2020 - 02.2021
Network Development Coordinator
SPNet Clinical Solutions/ SPNet Medical, Inc
10.2016 - 01.2020
Contracts Coordinator
Magnolia Health
07.2013 - 08.2016
Management Analyst
NaphCare, Inc
01.2011 - 03.2013
Front Office Manager
Lemak Sports Medicine
10.2007 - 07.2010
Associate of Applied Science - Applied Science
Bevill State Community College
08.1997 - 05.1999
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