TENNILLE MAYLE
Waterford,USA
Summary
Experienced credentialing professional with over 15 years of experience in healthcare operations and provider enrollment, expert in credentialing database management and team leadership. 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. Seeking a Director of Credentialing & Enrollment position at your company, where I bring my extensive credentialing and enrollment expertise to support your mission of ensuring every Registered Dietitian in your network is licensed, credentialed, and providing care across all operational states.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Director of Credentialing
UnisLink
Phoenix, AZ
09.2019 - Current
- Oversee all aspects of provider credentialing, recredentialing, and payor enrollment processes across multi-state networks
- Ensure data integrity and compliance with CMS and payor standards through routine audits and corrective action planning
- Develop and monitor department KPIs and QA metrics to evaluate performance and improve processing efficiency
- Lead initiatives to streamline workflows, enhance turnaround times, and reduce data discrepancies
- Partner with IT and compliance teams to implement and optimize credentialing and provider data management systems
- Train and mentor staff on credentialing policies, system usage, and regulatory requirements
Senior Billing Coordinator
Ohio Valley Health Care
Parkersburg, WV
10.2014 - 09.2019
- Managed end-to-end billing for a skilled nursing facility, ensuring accurate and timely claim submission to Medicare, Medicaid, and commercial insurance payors
- Reviewed and corrected UB-04 claim forms to ensure compliance with payor and regulatory requirements
- Investigated and resolved claim denials and rejections, reducing outstanding A/R and improving cash flow
- Coordinated with clinical and admissions teams to verify resident eligibility and authorization prior to billing
- Conducted monthly reconciliation and prepared reports for leadership detailing aging, collections, and reimbursement trends
- Assisted with payor audits and maintained documentation to support billing accuracy and compliance
- Supported implementation of new billing software and streamlined workflows to improve efficiency and reduce billing errors
Corporate Compliance Officer & Senior Billing and Credentialing Specialist
Schwab & Associates
Parkersburg, WV
08.2010 - 10.2014
- Monitored corporate compliance initiatives and maintained documentation to meet federal and state regulatory requirements
- Conducted internal audits to verify adherence to credentialing, privacy, and billing protocols
- Collaborated with leadership to update policies, corrective action plans and process improvement initiatives
- Facilitated as a liaison between compliance, quality assurance, billing and provider enrollment teams to ensure consistent operational integrity
Education
Bachelor of Science - Elementary Education
West Virginia University At Parkersburg
Parkersburg05-2005
Skills
- Provider Credentialing & Recredentialing Compliance
- Provider Data Management
- Multi-State Provider Enrollment Management
- Payor Relations & Application Tracking
- Project Planning & Workflow Optimization
- Quality Assurance & Data Integrity
- Cross-Functional Team Collaboration & Communication
- Credentialing Software Implementation Support
- Audit Preparation & Corrective Action Oversight
- Client & Provider Relationship Management
- Staff Training & Workshop Facilitation
- KPI Tracking & Reporting
Accomplishments
- Boosted Team Efficiency: Increased department efficiency by 20%, enhancing team leadership in credentialing operations within one year.
- Enhanced Compliance Standards: Trained over 45 staff, leading to a 25% compliance improvement through enhanced credentialing standards.
- Lowered Payer Denial Rates: Achieved a 15% reduction in claim denials through a strategic payer enrollment strategy implementation.
Certification
- CPES Certification - anticipation date Summer 2026
Languages
English
Full Professional
Timeline
Director of Credentialing
UnisLink
09.2019 - Current
Senior Billing Coordinator
Ohio Valley Health Care
10.2014 - 09.2019
Corporate Compliance Officer & Senior Billing and Credentialing Specialist
Schwab & Associates
08.2010 - 10.2014
Bachelor of Science - Elementary Education
West Virginia University At Parkersburg