Manager credentialing and Medical Staff Provider Enrollment
Resume:
MICHELE MANN COWGILL
Haslett, MI 48840
****.*******@*****.***
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Medical Staff Services Professional with 9 years of experience including Management experience in credentialing, provider enrollment and regulatory compliance for acute care hospitals and specialty hospitals. Most recently as Manager of Credentialing & Provider Enrollment encompassing multiple states in the Midwest Region specializing in Ophthalmology. MEDICAL SERVICES PROFESSIONAL SKILLS SUMMARY
● Meeting Management
● Payer Enrollment
● Initials & Reappointments
● Expirables
● Bylaws
● Privilege Forms
● Auditing
● FPPE/OPPE trained
PROFESSIONAL EXPERIENCE
Midwest Vision Partners, Chicago, Illinois March 2022 – June 2024 Manager Credentialing & Payer Enrollment
● Managed team of six payer enrollment specialists
● Coordinated and lead staff on workflows, spreadsheets, and credentialing databases
● Trained and mentored employees conducting weekly sessions
● Conducted performance improvement plans and annual performance reviews
● Provider Enrollment (Medicare, Medicaid, Workers’ Compensation and Commercial plans for multiple states in the Midwest Region)
● Primary liaison for practices, clinics, payers, revenue cycle management, billing and practitioners
● Primary contact for onboarding; developed onboarding process when none existed
● CAQH development and maintenance
● Verifications of credentials and importing to database
● Auditing of database
● Point of contact for escalated issues involving payer enrollment to the C-Suite, Regional Directors and Practice Managers
● Primary person responsible for initiating appointment applications and reappointments for Medical Doctors with various hospitals and surgical centers across the Midwest Region. Naples Community Hospital & NCH Healthcare System January 2021 – February 2022 Manager Credentialing
● Managed team of four credentialing specialists and one credentialing assistant for an acute care hospital
● Coordinated and monitored the accreditation, credentialing, privileging and re-credentialing processes
● Collected, verified and processed all new Medical Staff and Allied Health Professional practitioner applications and reapplications and privileging
● Meeting management coordinated, prepared, and oversaw all medical staff meetings, committee meetings, including Medical Executive Committee (MEC); attended and prepared meeting minutes and materials utilizing PowerPoint providing executive assistance to the Chief Medical Officer and President of the Medical Staff.
● Prepared reports to medical staff departments, committees, peer review panels, Medical Executive Committee (MEC), General Staff Meetings, Administration and Boards
● Managed the credentialing database system to ensure all updates are made accurately
● Project Manager for developing and implementing a robust onboarding process for Physicians and Allied Health Professionals where none existed
● Reviewed and updated as necessary standardized credentialing forms and delineation of clinical privilege forms and proctoring protocol and bylaws
MICHELE MANN COWGILL
1846 Sunhollow Court
Haslett, MI 48840
****.*******@*****.***
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● Participated in the Joint Commission audit as well as managed care audits. Long Beach Memorial Hospital & Miller’s Women’s and Children’s Hospital August 2015 – January 2021 Executive Assistant Medical Staff Services & Patient Quality
● Provided executive assistance to the Chief Medical Officer, Chiefs of Staff, Chief Quality Officer and Director of Medical Staff Services for acute care hospital and specialty hospital for Women & Children.
● Meeting management included scheduling, coordinating in all specialty areas, preparing meeting materials and facilitating for various committees
Medical Executive Committee
Credentialing Committee
Quality Review and Performance Improvement
Patient Safety & Risk Management
Culture of Safety
Medical Professionalism
Bioethics
Policy & Procedure Manual Review
Medical Staff Annual Meeting
Leadership Conferences
Medical Staff Orientation
● Prepared reports to medical staff departments, committees, peer review panels
● Managed the credentialing database system to ensure all updates are made accurately
● Project Manager for developing and implementing a robust onboarding process for Physicians and Allied Health Professionals where none existed
● Reviewed and updated as necessary standardized credentialing forms and bylaws ADDITIONAL QUALIFICATIONS
Software / Technology Proficiency Medallion, MDStaff, MDAccess, Echo, Credential Stream Microsoft Office – Outlook, Word and Excel
Google Docs
Powerpoint, Adobe, Visio
Education Lansing Community College – 30 credits Business Administration Mason High School, Mason, MI
Certifications / Licensure
University of Michigan - LEAN Process Improvement
Memberships / Associations Member of NAMSS
Other
25 years Human Resources Experience
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