Data Entry Billing Coordinator

Irma Vanegas

Email: **********@*****.*** Cell: 678-***-****

Analytical and knowledgeable Provider Enrollment / Credentialing Specialist with broad and deep knowledge of the healthcare industry.

Core Strengths:

- Strong Organizational Skills - Detail & Result Oriented

- Strong Work Ethic - Data Entry

- Leadership skills - Positive Personality

Proficient in the following software:

- IntelliSoft - Cactus - CAQH - SharePoint - DocuSign - Adobe Sign

- Microsoft Office - Spreadsheets - QuickBooks - PowerPoint - Emails - Mail Merge Professional Experience

Sonder Health Plans

Credentialing and Provider Data Management Supervisor (Manager) (May 2021 – Current)

- Startup company – I assisted with creating companied policies and procedures, in house system building

(AURA), Contracting and Processes.

- Work closely with Leadership, CEO’s and other departments

- Hiring and training all new employees. Assigning daily tasks

- Organized and Held Monthly Credentialing Committee Meeting

- Credentialing Facilities and Providers using CMS regulations. Responsible for all delegated credentialing.

- Responsible for the quality and accuracy of the data.

Benevis, LLC (DSO organization)

Lead Credentialing & Onboarding Specialist (July 2012 – February 2021)

- Responsible for all initial and recredentialing enrollments for the state of GA, VA, WVA, DC, MD, AL, MA, RI, and TX.

- Collected documents from new hired providers and completed CAQH applications and mapped applications using IntelliSoft.

- Enrolled providers with Medicare, Medicaid, Tricare, and Commercial payers.

- Developed and Maintained relationships with Network Representatives.

- Data Entry of providers information using IntelliSoft.

- Work in conjunction with A/R and EDI to resolve complex provider hold issues.

Benevis, LLC (Kool Smiles)

Medicaid and Commercial A/R Supervisor (May 2011 – July 2012)

- Responsible for training the accounts receivable team on claims processing and procedures.

- Completed monthly audits for each A/R specialist and provided feedback on improvement.

- Worked closely with the Credentialing department and was able to resolve over 1.5M in revenue that was rejected due to provider enrollment status.

- Assisted the billing team to ensure claims were being processed with correct attachments and x-rays to clear up rejected A/R correspondences.

Benevis, LLC (Kool Smiles)

Commercial Verifications and Billing Coordinator (September 2009 – May 2011)

- Verified Dental insurance coverage and plan details with Commercial Payers.

- Processed dental claims with correct charting of procedure codes and teeth numbers.

- Responsible for assigning daily tasks to my team of 22 verification specialists and 20 billing specialists.

- Trained new employees and completed monthly audits for each team member. Educational background: Campbell High School – Smyrna, GA – High School Diploma 2014 – 2018 References Available upon request

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