Summary
Overview
Work History
Education
Skills
Certification
References
Timeline
Generic

Wendy Boyd

Duluth,MN

Summary

Efficient professional with experience in competency-based performance, electronic applicant screening, and employee / labor relations. Frequently praised as focused by peers, I can be relied upon to help your team achieve its goals.

Overview

5
5
years of professional experience
1
1
Certification

Work History

Credentialing Specialist

St Lukes Hospital
12.2021 - Current
  • Supports the credentialing processes for the St Luke's, Lake View Hospital and Lake Superior Credentials Verification Services
  • Process provider applications and ensure compliance
  • Responsible for maintaining and updating credentialing data in the credentialing systems, tracking licenses, sponsorship, advancements and certification expirations for all providers to ensure timely renewals, processing affiliation verification requests, performing post board procedures, processing reappointment applications, updating payer rosters, providing support to the Credentialing Coordinator for meeting preparations and performing other duties as assigned
  • Ensures all processes and verifications meet the DNV, CMS and National Committee for Quality Assurance (NCQA) Medical Staff standards, serviced before and after procedures
  • Establish professional working relationships with providers, internal departments and payor reps
  • Audit files following SOP, Identify and correct errors
  • Responsible for maintaining, updating and completing all open applications.
  • Ability to work virtual or in person
  • Fluent with credentialing system Credential Stream and MD Staff

Billing Specialist

UHC
11.2018 - 07.2021
  • Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment; including coordinating with payers, patients and clients when appropriate.
  • Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR.
  • Demonstrate understanding of the whole accounting cycle / claim life cycle
  • In-depth working knowledge of the various applications associated with the workflows
  • Ensure all workflow items are completed within the set turn-around-time within quality expectations
  • Able to analyze EOBs and denials at a claim level and find trends impacting dollars
  • Knowledge of Managed care and Government programs

Education

High School Diploma -

Northfield Senior High School
Northfield, MN
01.2000

Skills

  • Works well with team and individually, as well as in office and virtually
  • Excellent communication and time management
  • Ability to shift priorities depending on order of importance
  • Dependable and open to constructive criticism
  • Strong computer skills; Credential Stream, MD Staff, Meditech, Windows, Excel, Word, Adobe

Certification

The Fundamentals of Medicare Level I, II, and III

References

Sarah Honneman—St Lukes Hospital/Medical Records Manager

(763) 607-3380

Sarah.honneman@slhduluth.com


Robyn Anderson—UHC/Manager 

(218) 279-5770

Robyn_k_anderson@uhc.com


Kyle Terrio-Johnson—Thrivent Financial Credit/Underwriter, Friend

(612) 816-5953

kyleterriojohnson@gmail.com

Timeline

Credentialing Specialist

St Lukes Hospital
12.2021 - Current

Billing Specialist

UHC
11.2018 - 07.2021

High School Diploma -

Northfield Senior High School

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