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Click here or scroll down to respond to this candidateCandidate's Name
Cuyahoga Falls, OH Street Address Phone: PHONE NUMBER AVAILABLEEmail: EMAIL AVAILABLEExperienced medical practice support professional with specific focus areas of medical billing& coding, physician credentialling, revenue cycle control, training, and general practice management functions.EXPERIENCE8/2022 TO PRESENTCONTRACT CREDENTIALING SERVICE PROIVDERAMP CREDENTIALINGProvide contracted credentialing services to various business medical entities.Oversee credentialing & licensing of new and current providers.Assure physicians and providers are properly set-up with private and public plans.Provide consulting services to clients specific to the credentialing process. 3/2021 9/2023CREDENTIALING & LICENSING ADMINISTRATORPSYCH360Process all incoming mail: open, sort and scan into SAI and Annie.Manage and process bank deposits including insurance reimbursements.Order office supplies and third-party print services.Support Human Resource functions including recruitment of staff, send Predictive Index assessments, set-up interviews, and process reference & background checks.Maintain Modio & CAQH for all providers.Oversee credentialing & licensing of new and current providers. Assure DEA & licenses are current.Coordinate DEA applications for all Nurse Practitioners.Support student clinical rotations: Post new student info in various systems, provide direct email support services, coordinate vaccination documents including COVID, TB, & flu, create and distribute preceptor agreements, schedule and communicate info regarding orientation sessions, provide current student roster info to all staff.Schedule new providers with various system training programs upon hire.Manage clozapine rems training for nurse practitioners. Coordinate communication on training session schedules as offered by NEOMED.Assist with patient insurance verification and eligibility checks.Coordinator employee events and functions both in-house and off-site.Set-up Continuing Medical Education sessions/lunches with various drug reps.Make hotel reservations, as needed, for new and existing employees.Oversee the credentialing/PCC access for Foundations Buildings.Maintain COVID data for providers. Process info requests upon receipt. 6/2012 2/2021BILLING, CREDENTIALING & INSURANCE SPECIALISTNORTHEAST OHIO EYE SURGEONS, INC.Managed revenue cycle functions including posting payments, electronic claims submission, appealing denials & scrubbing claims.Maintained physician CAQH data & profiles.Completed credentialling services for all physicians (adding new providers, information updates, etc.) for public and private insurance plans.Requested & managed insurance referrals from Primary Care Physicians.Verified & processed patient insurance (vision and medical) coverage.Posted & billed ambulatory surgery center charges.Handled office tasks including phones, patient registration, customer service duties.Supported practice expansion following numerous acquisitions.Generated and published various recurring financial reports (proficient in Microsoft Excel).Trained staff (new hires and recurring) on systems and procedures. 1/2000 5/2012RECEPTIONIST / PERSONAL SECRETARYSUMMIT OPTHALMOLOGY1/1995 1/2000DATA ENTRY CLERKBELL OPTICALEDUCATION1995GENERAL STUDIES / GED CUYAHOGA FALLS HIGH SCHOOLSYTEMS SUMMARY & SPECIALIZED SKILLS MedFlow / MedFlow EMR Allscripts Practice Management Allscripts Payerpath Clearinghouse Athena ICD-9 / ICD-10 HIPAA Patient Privacy Online claims processing (VSP, EyeMed) Support of expanding, multi-site medicalpractice Detail-oriented and accurate Strong computer skills Fast learner & highly adaptable Exceptional customer service skillsREFERENCE INFORMATIONBRYAN BACKUSCLINICAL PROVIDER, PSYCH360PHONE: PHONE NUMBER AVAILABLEEMAIL: EMAIL AVAILABLELORI DURKINMANAGER, NORTHEAST OHIO EYE SURGEONS, INC.PHONE: PHONE NUMBER AVAILABLEEMAIL: EMAIL AVAILABLESCOTT C. BIBLEASSOCIATE PROFESSOR OF PRACTICEUNIVERSITY OF AKRONCOLLEGE OF BUSINESS ADMINISTRATIONPHONE: PHONE NUMBER AVAILABLEEMAIL: EMAIL AVAILABLEDAVID J. DIXONDIRECTOR OF HUMAN RESOURCESKENT STATE UNIVERSITYCOLLEGE OF PODIATRIC MEDICINEPHONE: PHONE NUMBER AVAILABLE EXT. 17523EMAIL: EMAIL AVAILABLE |
