Gina Warren
Director, Credentialing and Payor Enrollment at Springstone, Inc.- Claim this Profile
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Bio
Credentials
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Certified Professional Medical Services Management (CPMSM)
NAMSS - National Association Medical Staff ServicesOct, 2022- Nov, 2024
Experience
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Springstone
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United States
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Hospitals and Health Care
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100 - 200 Employee
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Director, Credentialing and Payor Enrollment
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Feb 2020 - Present
Leadership and direction of the enrollment of physicians and advanced practice providers with Medicare, Medicaid, Medicare Advantage, Managed Care Organizations, and commercial insurance carriers across 13 behavioral health hospitals in multiple states. • Physician group contract review/negotiation of favorable terms and market competitive fee schedules. • Business owner for various software programs used in the clinical and business office environments including MediMobile and MD Staff. Responsible for contract language review, fee schedule negotiation, and execution of insurance contracts for physician groups. • Renegotiated multiple insurance contracts resulting in $150k revenue increase in first year of employment. • Converted paper processes to automated software solutions for medical staff credentialing, privileging, and payor enrollment. Show less
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Kindred
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United States
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Hospitals and Health Care
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700 & Above Employee
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Senior Director of Coding and Credentialing
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Jan 2013 - Nov 2017
Development, implementation and monitoring of all medical record coding and medical staff credentialing policies, procedures, and operations for 70+ hospitals. Direct leadership of a team of coding and credentialing managers and consultants. Assure compliance of coding and credentialing practices with CMS, The Joint Commission and state regulatory agencies. Provide visionary leadership for growth opportunities, provide consulting to individual hospitals, and retain accountability to local, regional and national leadership for accurate and timely coding practices as well as accurate and timely medical staff credentialing practices. Show less
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Director of Coding & Credentialing
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Apr 2009 - Dec 2012
Provide coding leadership and overall management of coding operations to 100+ hospitals nationwide. National credentialing leader responsible for policy-setting, software selection and process standardization for same 100+ hospitals. Increased DRG coding accuracy to 96% via audits, monitoring and education.
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Director of Transcription
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Dec 2008 - Mar 2009
Leadership of transcription operations for internal and external transcription operations. Management of 30+ employees and company liaison for national transcription agreement with outsourced vendor. Combined two large transcription offices into a single telecommute workforce.
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Kindred Healthcare
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Louisville, KY
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Manager of Transcription
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Sep 2000 - Nov 2008
Staff management of internal transcription department and support for national outsource transcription contract. Established the first telecommute work force program for Kindred Healthcare. Model created was used across the division to launch other telecommute departments. Consistently scored 5 out of 5 on customer satisfaction surveys. Staff management of internal transcription department and support for national outsource transcription contract. Established the first telecommute work force program for Kindred Healthcare. Model created was used across the division to launch other telecommute departments. Consistently scored 5 out of 5 on customer satisfaction surveys.
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Education
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2009 - 2012
Webster University
Master of Business Administration (M.B.A.), Business Administration and Management, General -
2006 - 2009
Indiana Wesleyan University
BS, Mgmt
Community
