Denise Thompson

• Work with patient's insurance company to verity benefits coverage, such as co-pay deductible, and out-of-pocket max.
• Accurately and efficiently document all call types and actions.

Review and identify information that is missing and/or incorrect within the application.

• Performed initial review for new providers to determine eligibility for enrollment into the network.
• Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
• Maintained detailed records of provider data in the credentialing database system.
• Conducted background checks on potential providers utilizing various resources including state licensing boards, OIG and GSA Exclusion List, NPDB.

• Perform audit of processes and procedures.
• Document and work to resolve complex calls problems.
• Responsible for driving accuracy and quality of claims.