Summary
Overview
Work History
Education
Skills
Websites
Timeline
Generic

Jennifer Moreno

Fort Wayne

Summary

Credentialing professional with expertise in managing and streamlining credentialing processes. Strong focus on compliance, accuracy, and timely completion of credentialing tasks. Effective in team collaboration, known for adaptability and reliability. Proficient in database management, policy implementation, and communication with stakeholders.

Overview

25
25
years of professional experience

Work History

Credentialing Assignment Coordinator

CHG Healthcare
11.2021 - Current
  • Contributed to company-wide initiatives aimed at strengthening internal processes and promoting continuous improvement efforts.
  • Participate in sales team meetings, stand-ups, and credentialing meetings to ensure alignment on objectives and operations.
  • Responsible for closing AC, tracking weekly numbers, and maintaining closing spreadsheets.
  • Handle engagement activity ops, surveys, and event coordination, contributing to team morale and client satisfaction.
  • Maintain accurate client and assignment details within internal systems, ensuring proper data entry for future planning.
  • Championed a proactive approach to problem-solving within the team, resulting in fewer delays or setbacks in projects.
  • Provided ongoing support to team members by answering questions, offering guidance, and sharing knowledge when needed.
  • Managed multiple projects simultaneously while maintaining strict deadlines, showcasing exceptional organizational skills.
  • Assisted in the development of standard operating procedures for the Assignment Coordinator role, ensuring consistency and quality in performance across the team.
  • Maintained detailed records of all assignments and their progress for easy retrieval and reference during planning meetings or client conversations.

Lead Credentialing Coordinator

Professional Medical Billing
06.2013 - 11.2021
  • Contributed to risk management initiatives by monitoring expiring licenses, certifications, and insurances, notifying providers of renewal requirements in a timely manner.
  • Coordinated continuing education opportunities for medical staff, promoting professional growth and development among affiliated providers.
  • Minimized potential legal complications by ensuring adherence to federal and state regulations governing healthcare practitioners'' licensure and certification requirements.
  • Worked closely with practitioners to help each obtain privileges at assigned healthcare facilities
  • Increased efficiency in data management by implementing a user-friendly database system for storing provider information.
  • Elevated client satisfaction rates through prompt resolution of any provider-related issues or concerns that arose during the credentialing process.
  • Communicated effectively with various parties each day using polished interpersonal and active listening skills.
  • Expedited the onboarding process for new medical staff by efficiently managing initial appointments and reappointments.
  • Served as a resource for departmental staff by maintaining a thorough understanding of current trends and best practices in the credentialing field.

Personal Lines Underwriter

Great American Insurance Company
05.2005 - 08.2007
  • Licensed in Property and Casualty insurance, working with clients to assess their needs and provide appropriate policy options.
  • Implemented effective risk mitigation strategies, reducing exposure to potential losses while maintaining a balanced portfolio.
  • Collaborated with claims department to ensure accurate evaluation of risks and appropriate pricing for policies.
  • Increased customer retention with thorough policy reviews and timely adjustments based on changing needs or circumstances.
  • Applied knowledge of standard criteria to approve or reject applications.
  • Underwrote personal lines of insurance, ensuring compliance with underwriting standards and accurate policy terms.

Claims Appeals Specialist

Lutheran Health Hospital
05.2000 - 05.2005
  • Specialized in high-dollar claims for hospital reimbursement, ensuring the timely resolution of disputes and payment processing.
  • Worked closely with insurance providers to ensure accurate documentation and appeal submission for denied claims.
  • Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
  • Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
  • Consistently met or exceeded performance metrics, demonstrating a strong understanding of the claims review process and an unwavering commitment to achieving positive results for clients.
  • Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
  • Regularly received commendations from supervisors for demonstrating exceptional commitment to customer service and dedication to client satisfaction throughout the appeals process.
  • Educated clients on their rights and responsibilities throughout the appeals process, ensuring a clear understanding of expectations and potential outcomes.

Education

Associate of Science - English

Indiana State University
Terre Haute, IN
05-1999

Skills

  • Medical Credentialing
  • Claims Follow-Up & Appeals
  • Insurance Contract Management
  • Regulatory Compliance (CMS, NCQA)
  • Medical Billing
  • Data Organization
  • Project management
  • Healthcare Management & Administration

Timeline

Credentialing Assignment Coordinator

CHG Healthcare
11.2021 - Current

Lead Credentialing Coordinator

Professional Medical Billing
06.2013 - 11.2021

Personal Lines Underwriter

Great American Insurance Company
05.2005 - 08.2007

Claims Appeals Specialist

Lutheran Health Hospital
05.2000 - 05.2005

Associate of Science - English

Indiana State University

Similar Profiles

CREATE PROFILE
Jennifer Moreno