Medical Management
Resume:
YRIBEL FERNANDEZ **** NW **th street
Lauderhill, FL 33351
**************@*****.***
SUMMARY OF QAULIFICATIONS
I am an enthusiastic and organized professional who possesses a high degree of integrity, creativity, personal character, and
common sense. Self driven and goal oriented who excels virtually in all aspects of job performance. Maintain a high level of
responsiveness and follow through combined with an equally high level of management, peer, and customer satisfaction.
PROFESSIONAL EXPERIENCE
Hospital Physician Partners, Plantation, Florida
November 2010 – Present
Provider Enrollment Coordinator
• Responsible for enrollment for all new individual providers with government plans (Medicare, Medicaid, Tricare, NPI, & BCBS) for all
contracted states including Locum Tenens.
• Responsible for notification to government agencies of resignations, terminations, reactivations.
• Assist in maintaining government pending log to update supervisor and other department on pending charges.
• Communicates with providers and/or others to obtain necessary documentation for submission of applications
• Entry of provider number in CPU database and verification of provider numbers to ensure proper and timely billing.
• Follow up with carriers in regards to pending applications and provider number issues.
Segadores De Vida, Hollywood, Florida
July 2006 – Present
Production Manager
• Overseeing the production process, drawing up a production schedule.
• Ensuring that the production is cost effective.
• Making sure that products are produced on time and are of good quality.
• Drafting a timescale for the each job.
• Being responsible for the selection and maintenance of equipment.
• Establish targets. Develop, review and modify goals and incentive programs which will motivate employees, encourage
teamwork and produce the most desired results for the company and clients.
• Work with teams of subject matter experts to remove waste, reduce cost, improve quality and delight our customers.
• Reviewing the performance of subordinates.
Sheridan Healthcorp Inc, Sunrise, Florida
March 2004 – July 2006
Credentilaing Coordinator – Clinic Services
• Responsible for all Provider Enrollment & Credentialing processes, systems support and maintenance.
• Responsible for the daily work flow of assigned providers; maintenance of provider credentialing documents.
• Manages and processes the provider/group new and established credentialing application process from start to finish,
which includes process standardization and improvement, developing, updating and monitoring individual and departmental
standards, workload management, problem resolution, follow up, and relationship building with all Medical Practice personnel,
including Area Practice Managers (APMs), Area Practice Administrators (APAs), Central Business Office(CB0) and payers, providers
and internal personnel regarding all facets of Credentialing/Provider Enrollment.
• Effectively obtains medical licenses and other required federal documents within strict timeframes to ensure approximately
2000 physicians and nurse practitioners may practice at appointed hospital sites.
• Liaison with Medical Boards, physicians, university affiliations, and hospitals in order to coordinate the receipt of multiple
documents used to complete privilege and credentialing packages.
Pediatrix Medical Group INC, Ft. Lauderdale, Florida
May 2002 – March 2004
Credentilaing Coordinator – Medical Licensure
• Effectively obtains medical licenses and other required federal documents within strict timeframes to ensure approximately
1000+ neonatal physician and nurse practitioners may practice at appointed hospital sites.
• Manages and processes the provider/group new and established credentialing application process from start to finish,
which includes process standardization and improvement, developing, updating and monitoring individual and departmental
standards, workload management, problem resolution, follow up, and relationship building with all Medical Practice personnel,
including Area Practice Managers (APMs), Area Practice Administrators (APAs), Central Business Office(CB0) and payers, providers
and internal personnel regarding all facets of Credentialing/Provider Enrollment.
• Effectively obtains medical licenses and other required federal documents within strict timeframes to ensure approximately
2000 physicians and nurse practitioners may practice at appointed hospital sites.
• Liaison with Medical Boards, physicians, university affiliations, and hospitals in order to coordinate the receipt of multiple
documents used to complete privilege and credentialing packages.
Elmhurst Hospital Center (Emergency Medicine Department) New York, New York
May 2001 October 2002
Medical Affairs Coordinator
• Responsible for the planning and coordinating of the Medical Staff Office in accordance with the Organization’s mission and
strategic goals and to meet the requirements of the Medical Staff Bylaws, and all applicable federal, state, and local regulatory and
accrediting agencies.
• Collaboratively coordinates and manages all medical staff organizational, administrative, credentialing and privileging functions.
• Maintained complete and accurate payroll and timesheet records for emergency room employees for the City and Mount Sinai payroll
division.
• Coordinate Center wide projects and activities, including interaction with practitioners and nurses, clinical policies/procedures, quality
improvement, patient satisfaction, disease management, patient education, and other special projects.
NYU Hospital Center (Pain Management Center) New York, New York
Medical Biller/Secretary May 1997- October 2000
• Prepared complex medical billing packages including No fault claims, workmen’s compensation, and all third party insurance carriers
to ensure proper and accurate payment was received.
• Verified insurance benefits to determine patient participation and completed additional paperwork for payment plans as needed.
• Handled account receivable and collections for billed items maintaining a high collectible balance and consistently met corporate
collection goals on a quarterly basis.
EDUCATION
American Medical Training Center 1994
Medical Assistant Degree
Trinity International University 2009
BA Management Organizational Leadership
TECHNICAL SKILLS
Microsoft Word, Excel, PowerPoint, Visio, Access and Outlook; ADS Billing system, Spectrasoft, MediBase, Goldmine
TRAINING AND CERTIFICATIONS
• Bilingual (Spanish)
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