Summary
Overview
Work History
Education
Skills
Timeline
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Veronica Hernandez

Temple

Summary

I'm an analytical and detail-driven healthcare professional committed to exceeding goals and delivering exceptional experiences. Compassionate and dedicated, with a strong focus on ensuring services are well coordinated and effectively managed to support overall company success.

Overview

4
4
years of professional experience

Work History

Provider Enrollment Representative

First Coast Service Options
01.2025 - 05.2026
  • Analyze Medicare provider enrollment applications to ensure compliance with CMS regulations and internal guidelines while maintaining strict accuracy and meeting production benchmarks in a high-volume environment.
  • Conduct fraud and exclusion screenings using Medicare databases to mitigate compliance risks and perform overpayment reviews and flag potential financial risks for further investigation
  • Review and identify discrepancies in provider data, resolving issues to prevent application delays or denials.
  • Utilize APEX, PECOS, MCS, and Excel to track, validate, and process enrollment data.

Medicare Enrollment Specialist

TTEC
01.2022 - 01.2025
  • Conduct detailed intake and submission of Medicare Advantage enrollment applications in a high-volume environment.
  • Maintain 100% accuracy standards while processing applications.
  • Ensure compliance with CMS regulations and enrollment guidelines during all submissions.
  • Identified and resolved discrepancies prior to submission, ensuring timely processing of applications.
  • Analyzed applicant information in real time, preventing errors and ensuring eligibility compliance.
  • Met performance and quality benchmarks consistently in a high-volume environment.

Education

High School -

Temple High School
Temple, TX, USA

Skills

  • Provider Enrollment
  • Credentialing
  • CMS Regulations & Compliance
  • Fraud screening
  • Overpayment analysis
  • Data Verification
  • System Navigation (APEX, MCS, PECOS)
  • Microsoft Excel

Timeline

Provider Enrollment Representative

First Coast Service Options
01.2025 - 05.2026

Medicare Enrollment Specialist

TTEC
01.2022 - 01.2025

High School -

Temple High School

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Veronica Hernandez