Summary
Overview
Work History
Education
Skills
Timeline
Generic

Whitney Okonski

Springfield

Summary

Dynamic healthcare professional with proven expertise in streamlining processes and enhancing efficiency through innovative software solutions. Skilled in provider credentialing and medical billing, I excel in problem-solving and delivering exceptional customer service. Committed to compliance and accuracy, I have successfully worked on complex projects and trained team members to uphold industry standards.

Overview

13
13
years of professional experience

Work History

MEDICAL AUDITOR

SAIF
Springfield
04.2025 - Current
  • Conducted audits of complex medical and financial data to identify discrepancies in billing or coding practices.
  • Ensured adherence to industry standards when conducting audits.
  • Reviewed and analyzed claims documents to ensure accuracy of information and compliance with company policies and procedures.
  • Evaluated medical necessity criteria for services rendered by providers according to state guidelines.
  • Paid and processed claims within designated authority level.

Credentialing Specialist / Third Party Representative & Analyst

Pacific Source
Springfield
01.2018 - 03.2025
  • Streamlined applications process while implementing new credentialing software by testing and collaborating to reduce errors, and improve efficiency in processing.
  • Maintained accurate records for credentialing and re-credentialing of providers; processed and verified applications in accordance with industry standards and guidelines.
  • Coordinated the collection and organization of required documentation, ensuring timely processing of credentialing files using both credentialing software and internal tracking systems (spreadsheets, databases).
  • Conducted thorough verification of provider credentials (licenses, certifications, training certificates) from state boards, national organizations, and hospitals to ensure compliance with legal and regulatory requirements.
  • Audited credentialing files for consistency, accuracy, and compliance; processed background checks and prepared provider profiles for review and approval.
  • Processed medical claims in Facets, ensuring accurate data entry and efficient resolution of patient claims.
  • Analyzed medical claims, reviewed diagnosis accuracy, and communicated coverage positions to resolve discrepancies.
  • Developed training materials, coordinated internal training sessions for new analysts, and reviewed existing claim processing procedures to identify and implement efficiency improvements.
  • Led cross-functional projects related to coordination of benefits, audits, and provider network data; worked with internal teams to resolve complex claims issues and drive process improvements.
  • Provided exceptional customer service to clients, resolving inquiries and managing multiple projects while maintaining high standards of performance.
  • Managed document storage, maintained thorough recordkeeping systems, and facilitated the submission of claims and related documents (attorney summaries, team emails, faxes).
  • Assisted in training and mentoring junior staff, offering guidance on best practices for claims processing and credentialing compliance.

PATIENT FINANCIAL REPRESENTATIVE / MEDICAL RECORDS / PROGRAM ASSISTANT

Cascade Health
Eugene
01.2013 - 01.2018
  • Managed workers' compensation billing, processed payments, posted customer payments, and maintained department A/R.
  • Conducted insurance follow-ups, resolved claim denials, and submitted appeal letters; communicated with insurance companies to expedite payment.
  • Assisted with training new employees on billing systems, account workflows, and compliance procedures.
  • Released medical records to patients, insurance companies, and physicians in compliance with HIPAA.
  • Handled drug screening processes for occupational health clients and new hires.
  • Provided front office support: filing, reception, scheduling appointments, answering multi-line phones, and maintaining organized patient charts.
  • Utilized Electronic Medical Records (EMR) to manage patient data and coordinate care documentation.
  • Supported referral coordination, processed physician orders via fax, and ensured timely follow-up with patients and insurance providers.
  • Managed inventory of office and medical supplies and maintained efficient office operations.
  • Worked across departments including Home Health, Hospice, and Occupational Medicine, supporting both administrative and clinical workflows.

Education

High School Diploma -

Willamette High School
Eugene, OR
01.2006

Skills

  • Provider credentialing
  • ICD-10 pro efficiency
  • Project management
  • Healthcare regulations
  • Medical coding certification
  • HIPAA compliance
  • Medical billing and coding
  • Certification maintenance
  • Medicare guidelines
  • Customer service
  • Problem solving
  • Multitasking
  • Attention to detail
  • Time management
  • Adaptability and flexibility
  • Organized and efficient
  • Credentialing software
  • Provider enrollment

Timeline

MEDICAL AUDITOR

SAIF
04.2025 - Current

Credentialing Specialist / Third Party Representative & Analyst

Pacific Source
01.2018 - 03.2025

PATIENT FINANCIAL REPRESENTATIVE / MEDICAL RECORDS / PROGRAM ASSISTANT

Cascade Health
01.2013 - 01.2018

High School Diploma -

Willamette High School

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Whitney Okonski