Summary
Overview
Work History
Education
Skills
Work Availability
Timeline
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Tracy L. White

Tracy L. White

Dayton,OH

Summary

Dedicated professional with a solid background of 23 years working in high-volume fast paced office environments in the healthcare industry. Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills. Achievements include completing more than 20 healthcare provider applications each month with no critical errors. Highly organized and detail-oriented with in-depth knowledge of NCQA regulations.

Overview

19
19
years of professional experience

Work History

Credentialing Specialist

Premier Health
Dayton, OH
10.2019 - 02.2023
  • Maintain high quality, timely and accurate credentialing processes for all medical and allied health professionals per NCQA and Joint Commission guidelines for MSO
  • Complete approxmatley 20 credentialing files per month ensuring that all correspondence in initial and reappointment process is accurately filed
  • Conduct primary source verifications including background checks, education and training
  • Receive and evaluate applications to look for missing and inaccurate information.

Medicare Billing QA Compliance Specialist

Premier Health
Dayton, OH
05.2008 - 10.2019
  • Completed auditing process by investigating billed Medicare claims and coding edits to ensure compliance with Medicare billing guidelines, procedures and risk management
  • Followed-up on denied Medicare claims for corrections in billing and coding errors to obtain proper reimbursement by working collaboratively with Medicare/CGS to resolve billing issues to stay in compliance and to ensure that claims are re-processed in timely manner.
  • Communicated with insurance providers to resolve denied claims and resubmitted.

Patient Accounts Specialist

Dayton Heart Hospital
Dayton, OH
01.2005 - 05.2008
  • Billed PPO/HMO medical claims in accordance with established procedures
  • Investigated and followed-up on claims for reimbursement and collections
  • Worked independently with patients to resolve payment issues
  • Completed insurance verifications, Pre-authorizations and assisted patients with completing HCAP applications and collecting payments
  • Responded to patient, family and external payer inquiries.
  • Posted payments

Medical Billing Specialist

Five Rivers Health Centers
Dayton, OH
06.2023 - Current
  • Skilled at working independently and collaboratively in a team environment.
  • Managed time efficiently in order to complete all tasks within deadlines.
  • Excellent communication skills, both verbal and written.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.

Education

Associate - Applied Science, Business Administration

Indiana Wesleyan University
2013

Skills

  • Technical Skills: Epic, Microsoft Office (Word, Excel, Outlook and Power Point), Billing Software
  • Credentialing software Cactus/Symplr
  • Performance Appraisal
  • Problem Resolution
  • Credentialing Policies
  • Credential Verification
  • Employee Hiring
  • Complex Problem-Solving
  • Analytical and Critical Thinking

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Medical Billing Specialist

Five Rivers Health Centers
06.2023 - Current

Credentialing Specialist

Premier Health
10.2019 - 02.2023

Medicare Billing QA Compliance Specialist

Premier Health
05.2008 - 10.2019

Patient Accounts Specialist

Dayton Heart Hospital
01.2005 - 05.2008

Associate - Applied Science, Business Administration

Indiana Wesleyan University

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Tracy L. White