Credentialing Associate - Planned Parenthood - St. Paul, MN
(2018-11 - 2027-08)
- Follow Standard work to ensure all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws.
- Lead transitions to Increased productivity and improved efficiency.
- Work with team to ensure timely processing of applications and contracts.
- Educate providers on credentialing and contracting guidelines and requirements.
- Communicate by telephone and write inquiries daily.
- Maintain and track Providers documents to ensure good standing.
- Initiates correspondence to providers and clients to obtain credentialing status.
Claims Collections Analyst II - Planned Parenthood - Saint Paul, MN
(2010-02 - 2018-11)
- Responsible for billing follow-up/collection on assigned accounts with government agencies, patients, and insurance organizations.
- Identified and resolved issues associated with denial management functions to maximize revenue, including posting insurance payments, and updating patient accounts in a time-sensitive manner.
- Researched and responded to phone and written inquiries from patients, members, and other payers regarding billing, account status, claim status, and eligibility issues.
- Recognized as subject matter expert on MFPP, Medicaid, Medicare, and Title X government funding programs.
- Reviewed billing claims for accuracy prior to submission for adjudication for both primary and secondary insurance payers.
- Generated and analyzed billing reconciliation reports for received payments, denied charges and outstanding bills.
