Student Resource Navigator

• Aug 2022 - Present

Provider Enrollment Representative

• Feb 2019 - Jul 2019

Researches, analyzes, and resolves from 10-30 enrollment applications and/or reports per day. • Reviewed and verify changed provider status information to determine continued provider eligibility • Interpreted and applied federal and state requirements for determining the eligibility of health care providers, provider groups, and other health care entities into Medicare & Medicaid. • Had daily external provider contact via Emails. • Used PECOS & MCS system prior to setup to ensure NPI’s are valid as well as provider specialty. • Assisted with other projects and duties as they assigned. • Ensured department turnaround time guidelines were met and accurate. • Used Medicaid verification as well as SAM & OIG Exclusion verification systems prior to setup to ensure that the entities and/or practitioners do not have any sanctions against them. Show less