Experience

Medallion

• United States
• Technology, Information and Internet
• 1 - 100 Employee

• • Apr 2023 - Present

  Over seeing an entire payer enrollment department size of 92 team size. Collaborating with counter departments of licensing, customer success, EPD and sales. Working with client relationships to build a relationship with these clients for a great experience. Working with Quality Assurance team to resolve any escalations and review RCA's and create Corrective action plans when needed. Performing 1 on 1's with direct reports (Managers) and skip level team teams as needed. Perform data analysis from a variety of data sources to evolve the metrics used to measure effectiveness and return on investment of all current and new product activity. Work closely with engineering team along with analytics to build products and platform improvements for payer enrollment teams. Show less

• • Nov 2022 - Present

• • May 2022 - Nov 2022

  Building quality assurance program for licensing department. Developed audits on a department level for specific job roles and clients. Researched any and all escalations to find any process breaks that need correction.

• • Jan 2022 - Nov 2022

  Monitoring team for PSV, overseeing team of 7 direct reports. Monitoring work loads, completing 1 on 1’s with direct reports.

• • Nov 2021 - Nov 2022

  Working on primary source verifications for medical providers.



STAT MedCare, LLC

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• • Feb 2021 - Nov 2021

  Was promoted to Senior Account Manger after being at the companyfor 3 months.• Assist Clients with Credentialing• Apply for Medical License for Clients to different states• Provide updates to clients of status applications• Negotiate contracts for Clients• Enroll Clients into Hospitals, Insurance plans.• Updating CAQH• Enrolling into PECOS and Medicaid Plans for many differentStates• Oversee more than 10 employee’s (account managers) and all ofthere accounts.• Approved time off through ADP Workforce for all employees• Attending weekly meetings with multiple clients to reviewproblems, needs, and current work• Worked with offshore processors to complete applications andfollow-ups Show less

• • Feb 2021 - May 2021

  • Assist Clients with Credentialing• Apply for Medical License for Clients to different states• Provide updates to clients of status applications• Negotiate contracts for Clients• Enroll Clients into Hospitals, Insurance plans.• Updating CAQH• Enrolling into PECOS and Medicaid Plans for many differentStates• Was in charge of all credentialing, privileging for a large company ofMore than 600 providers



Contractor

• Sweden
• Construction
• 1 - 100 Employee

• Credentialing Manager

  • Nov 2018 - Dec 2020

  - Assist client with Credentialing and Provider Enrollment - Apply for Medical Licensing to all 50 states. - Provider updates to client of current status of applications for enrollment and licensing. - Contract negotiations for clients for various commercial plans - Enrollments for Hospital Privileges and surgery centers - Updating and managing CAQH for multiple providers - Enrolling into PECOS and Medicaid plans for many different states. - Assist client with Credentialing and Provider Enrollment - Apply for Medical Licensing to all 50 states. - Provider updates to client of current status of applications for enrollment and licensing. - Contract negotiations for clients for various commercial plans - Enrollments for Hospital Privileges and surgery centers - Updating and managing CAQH for multiple providers - Enrolling into PECOS and Medicaid plans for many different states.



Cape Fear Eye Associates, PA

• United States
• Medical Practices
• 1 - 100 Employee

• Ophthalmic Assistant

  • Feb 2015 - Aug 2016

  • Pre-testing patient’s before seeing doctor • Performing scribe duties with Doctors • Maintain and set up patient rooms • Assisting in testing, exams, and surgical procedures • Assistant to Retina Doctor, maintaining doctor schedule • Ordering all medical supplies for office • Updating patient EHR records • Following up patient care plans and appointments. • Reviewing charts for billing and selecting codes for billing. • Pre-testing patient’s before seeing doctor • Performing scribe duties with Doctors • Maintain and set up patient rooms • Assisting in testing, exams, and surgical procedures • Assistant to Retina Doctor, maintaining doctor schedule • Ordering all medical supplies for office • Updating patient EHR records • Following up patient care plans and appointments. • Reviewing charts for billing and selecting codes for billing.



Direct Optical center

• Optician

  • Feb 2014 - Jul 2014

  • Assist patients with making frame selections • Assisted patients with lens choices to fit their needs • Maintain and set up patient rooms • Ordering of all contact lens orders (Hard and Soft lenses) • Assist new contact lenses wearers with correct insert and removal care of lenses. • Making appointments • Taking payments from patients • Adjusting frames to fit each person properly • Answer multi-line phone, operate fax and copy machine • Filed claims and authorizations for insurance companies as Eyemed, VSP, Humana, Comp Benefits, Spectra, BCBS, and many more. Show less



Optometry Clinic

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Receptionist/Optometric Technician

  • Aug 2009 - Dec 2010

  Answering phones and directing calls. Contact lens trainings. Preliminarily and Post testing of patients for doctor. Update patient records with notes and billing codes. Filed and pulled authorization for numerous insurance companies. Provider enrollment for existing provider's and performing revalidation's and licensing as needed. Answering phones and directing calls. Contact lens trainings. Preliminarily and Post testing of patients for doctor. Update patient records with notes and billing codes. Filed and pulled authorization for numerous insurance companies. Provider enrollment for existing provider's and performing revalidation's and licensing as needed.