Hospital Billing Medical Credentialing

SHERRI RENEE MITCHELL

**** ******** ***** *** *** RALEIGH, NC 27612 (718) 607- 8711 **********@****.*** HTTPS://WWW.LINKEDIN.COM/IN/SHERRI-MITCHELL-63B55832/ MEDICAL CREDENTIALING ANALYST

HOSPITAL BILLING• HEALTHCARE MANAGEMENT & STRATEGIC PLANNING • PAYER RELATIONS Value-driven and seasoned professional accustomed to addressing inquiries from providers and or PO’s, as well as interface with internal and external customers on day-to-day credentialing and privileging issues as they arise. Contributor to performance management targets by maintaining the set average handling time and adhering fully to scheduled breaks/rosters. Ability to use independent judgment to manage and impart confidential information and demonstrate expertise in hospital billing. Serve as the point of contact for addressing inquiries from providers, management, health plans, and other parties regarding credentialing for various facilities. Support in monitoring and evaluating the performance of staff; give timely feedback; and manages all aspects of staffing to include hiring, training, rewarding, disciplining, and terminating staff. Adhere strictly to policies and procedures in compliance with industry standards and best practices, as well as local, state, and federal laws and regulatory requirements o Highly qualified, talented, tenacious, and well-accomplished professional with 18 years’+ experience armed with broad-based background and recognized as a business service coordinator, sales specialist, and trainer with team building initiatives.

o Posses solid ability to maintains the data integrity and functionality of credentialing database; generates reports and prepares audits as requested.

Signature Strengths:

Healthcare Information Technology • Medicare & Medicaid • Public Health • HIPAA • Team Leadership •Healthcare Consulting • Medical Billing • Collections • Patient Safety • Health Insurance• Marketing Strategy • Records & Documentation

• EMR & Epic Systems• Medical Terminology • Salesforce • Training & Development • Relationship Building PROFESSIONAL EXPERIENCE

HCL America Dec 2020-Current

Medical Credentialing Analyst

Overview: Hired to leverage Credentialing or provider file maintenance expertise for various health plans while demonstrating ability to remain calm in potentially stressful situations with medical professionals.

Influenced customer satisfaction score by delivering an exceptional experience for customers while complying with policies and procedures.

Modernized capabilities within the organization through driving high KPI performance in a US health care process Curi-a Medical Mutual Company Raleigh, NC Oct 2018- Dec 2020 Credentialing Specialist

Overview: Recruited to provide optimal oversight in processing applications and reappointment paperwork with utmost professionalism.

Championed the process of handling verification and accreditation information while ensuring proper database management and updates for practitioners and facilities.

Masterminded efforts to utilize the system for entering and maintaining Provider applications, contracts, and updates.

Boosted workflow efficiency and professional development through engaging in training and reference materials including content, work instructions, and tools.

Visiting Nurse Service of New York, NY Oct 2010 –Jul 2018 Insurance Coordinator

Overview: Designated to drive growth through executing strategic initiatives focused on driving prompt completion of computer-generated and manually prepared billing.

Promoted growth through researching and processing denials, including insurance verification.

Enhanced quality outcomes by facilitating prompt follow-up while addressing and remediating billing issues with tact and demeanor.

Turned around poor performance through utilizing appropriate documents such as I9’s and NPI’s for reconciling data input.

Streamlined the process of preparing accurate record documentation on various operations while utilizing the payer systems for entering and communicating information. Health Care Partners, Inc, Garden City, NY Jan 2004 –Jul 2010 Licensed Sales Specialist-Senior Plans

Overview: Demonstrated mastery in scheduling appointments while fostering and maintain solid relationships with prospects to evaluate strategic plans.

Leveraged expertise in driving corporate sales objectives in alignment with strategic development plans through cross-selling company’s events and health plan events as well as facilitated home visits.

Aligned the organization for growth through meeting and exceeding daily sales and productivity goals established by the management team.

Laid groundwork to improve execution of various marketing events while enhancing the functional knowledge of eligible (Part A & B) prospects to enroll them into contracted health plans that meets their needs. Stericycle, Inc., Roslyn Heights, NY Sept 2000 – Jan 2004 Senior Representative/Collections

Overview: Piloted the process of maximizing product sales and maintained consistency in addressing various issues in collaboration with the sales force.

Fostered and strengthened solid relationships while spearheading the team to execute assigned projects.

Served as the main point of contact for handling high volume of incoming calls in a call center setting. EDUCATION

York College, Jamaica, NY

Major: Business

Leavenworth High School,

Major: General Studies

LICENSURE & CERTIFICATION

NYS Insurance Accident & Health

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