Enrollment Specialist Medical Assistant
Resume:
Professional Summary
Analytical and knowledgeable Provider Enrollment Specialist with extensive knowledge of credentialing and enrollment and has extensive experience in the healthcare industry.
Core Qualifications
Good written and oral communication skills
Extensive knowledge of conducting eligibility interviews
Strong analytical skills
Understanding of insurance regulations and enrollments
Able to answer questions regarding insurance products
Strong knowledge of credentialing process for providers
Above-average computer skills and knowledge of applicable computer applications
Experience:
August 2017 – February2022 Float Medical Receptionist/Medical Assistant
Clinical Associates Towson, MD 21286
Completed patient registration.
Processing of and preparation of new patient files.
Scan and update patient’s insurance cards and information.
Verify member insurance eligibility.
Check in patients and take payments.
Answer incoming and internal phone calls.
Schedule appointments.
August 2011 – December 2016 Team Lead Provider Enrollment Specialist
Xerox Healthcare Solutions Washington, DC 20002
Completed credentialing applications for providers
Processing of and preparation of new provider enrollments.
Completed dis-enrollments as needed.
Verified and corrected member eligibility issues at least monthly.
Communicated with members and doctors regarding benefits.
Utilized state enrollment systems and managed care enrollment systems.
Conducted all work in accordance with the confidentiality requirements mandated by HIPAA for member information.
Verified eligibility for all departments and completed updates of Managed Care System.
Reported enrollment trends and all problems to management at weekly meetings.
Monitored all enrollments to identify any processing problems.
August 2008 – August 2011 Receptionist/Customer Service
Children’s Healthcare Center Waldorf, Maryland 20603
Answer Customer/Patient Calls
Schedule appointments
Prepare patient charts
Verify insurance
Verify Medicaid & Medicare Provider Enrollment with CMS
Posting payment and charges
Process claims while monitoring CPT/ICD-9 coding
November 1999 – June 2007 Inventory Clerk
Melwood Training Center 2600 5606 Dower House Road Upper Marlboro, Maryland 20772
Maintain vehicle donation data base
Update customer files,
input sold information for vehicles
match sold information with donations and file
run daily tow reports,
prepare monthly inventory reports for the director and finance
Education
August 2009-December 2010 Sanford Brown Institute
HIPAA Certified
Certificate in Medical Billing and Coding
Knowledge of Nexgen software
Certificate of completion in Medi-Soft
CPR Certified
Medical Assistant Program
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