Organize regularly scheduled meetings as needed to update Provider Enrollment Coordinators on new policies and procedures.
Schedule educational meetings as needed for current enrollment procedures.
Participate in organizational monthly meetings with delegated payer plans.
Produce and send biweekly roster updates to delegated payers.
Monitor for issues that emerge with providers' enrollments with payers.
Monitor expirable reports to ensure provider information is updated with delegated payers, government payers, and CAQH.
Run monthly reports to monitor revalidations due for government payors.
Provider Enrollment Coordinator
Mercy Health System Pho
Rockford, IL
08.2015 - 05.2024
Maintained accurate records of all provider enrollments and re-enrollments.
Verified provider enrollments with delegated payers and government payers.
Collaborated with internal departments such as billing, customer service, and compliance.
Communicated regularly with providers, payers, and internal teams regarding the status of their applications.
Updated and maintained provider records in CAQH ProView.
Updated and maintained provider records in the National Plan and Provider Enumeration System (NPPES).
Produce and send biweekly rosters to delegated payers.
Prepare the requested documentation for delegated payers for audits.
Education
Bachelor of Science - Business Management Studies
Rockford University
Rockford, IL
06-2013
Skills
CMS Identity and Access Management System
CMS National Plan and Provider Enumeration System – NPPES
Medicare Provider Enrollment, Chain, and Ownership System – PECOS
CAQH ProView
Microsoft Office 365
Credential Stream Credentialing Software
Affiliations
Currently participating with the National Association of Medical Staff Services (NAMSS) in the development of a Certified Provider Enrollment Specialist (CPES) certification exam tobe offered for the first time in Fall 2025.