Open to opportunities

Anika Brown Dyer

@anikabrowndyer

Message

Credentialing Specialist with expertise in provider enrollment and claims resolution.

United States

Message

What I'm looking for

I am looking for a role that values collaboration and offers opportunities for professional growth in healthcare credentialing.

I am a dedicated Credentialing Specialist with extensive experience in provider enrollment and claims resolution. My role at ABA Centers involved managing complex credentialing inquiries and resolving over $20,000 in denied claims, showcasing my ability to navigate intricate systems and ensure compliance with state and board licensing requirements.

With a strong foundation in data analysis and a commitment to patient privacy regulations, I have successfully implemented efficient onboarding processes and utilized AI tools to identify inaccuracies in credential claims. My educational background includes multiple certifications in medical scheduling, business operations, and data analysis, which further enhance my capabilities in this field.

I thrive in collaborative environments and am passionate about improving operational efficiency. I am eager to bring my skills to a dynamic team where I can contribute to enhancing provider enrollment processes and ensuring high-quality service delivery.

Experience

Work history, roles, and key accomplishments

Current

Credentialing Specialist

Current

ABA Centers

May 2024 - Present (1 year)

Tracked State/Board, Licensing Expirables, Telehealth, and NPI data. Managed onboarding, VOB, SCA, and Admission Credentialing Inquiries. Resolved over $20,000 in denial claims due to potential credentialing issues.

State Licensing Boards NPI Data Tracking Onboarding VOB SCA Credentialing AI For Claims Analysis OON Rostering

Current

Credentialing Specialist

Current

ABA Centers

May 2024 - Present (1 year)

Managed state and board licensing, NPI data tracking, and telehealth expirables. Handled onboarding, VOB, SCA, and admission credentialing inquiries. Resolved over $20,000 in denial claims and identified payor inaccuracies using AI.

State Licensing Boards NPI Data Tracking Credentialing Onboarding VOB SCA Admissions

Medical Scheduler/Medical Credentialing

My Psychiatrist

Jun 2020 - May 2024 (3 years 11 months)

Ensured adherence to patient privacy regulations and HIPAA compliance. Performed PSV initial and re-credentialing using NCQA, CAQH, and Availity platforms. Resolved complaints and processed in-network payor credentialing applications for NPI 1 and NPI 2.

HIPAA CAQH Availability NPI 1 & 2

Strategic Planning Training & Development/Quality Analyst Auditor

Engagement Health

Sep 2018 - May 2020 (1 year 8 months)

Monitored and coached healthcare sales representatives on phone interactions. Implemented fraud prevention alerts and created training presentations and SOP modules. Conducted internal call compliance calibrations and tracked performance.

Fraud Prevention Performance Tracking

Training & Development/Quality Analyst Auditor

Engagement Health

Sep 2018 - May 2020 (1 year 8 months)

Monitored and coached healthcare sales representative phone interactions. Implemented training presentation creation and SOP modules. Conducted internal call compliance calibrations and tracked performance.

Sales Coaching Fraud Prevention Performance Tracking

Customer Service Operation

Call Center TPUSA

Jan 2014 - Aug 2018 (4 years 7 months)

Handled enrollment status, retention, EOB, and call rescheduling for Molina HealthCare. Provided tech support for LMS navigation at McGraw Hill Education. Conducted training and quality auditing for Hughes NET.

Customer Service Retention Tech Support Auditing Modem Configuration

Customer Service Operation

Call Center TPUSA

Jan 2014 - Aug 2018 (4 years 7 months)

Served in multiple customer service roles, including Training & Quality Auditor and Tech Support. Responsibilities spanned enrollment status, retention, EOB, call rescheduling, and health plan comparison. Provided technical support for LMS navigation and modem configuration.

Customer Service Technical Support Modem Configuration Investigation

Education

Degrees, certifications, and relevant coursework

Broward County Certificate Program

Certificate Program, Medical Credentialing

2020 - 2022

Grade: Completed

Completed certificates in Medical Scheduler/Medical Credentialing, Business Operations, Excel Data Analysis, and Data Analysis. Also obtained a Lean Six Sigma Green Belt Certificate.

Broward County Certiﬁcate Program

Certiﬁcate Program, Medical Credentialing, Business Operations, Data Analysis

2020 - 2022

Grade: Completed

Completed multiple certificate programs covering Medical Scheduler/Medical Credentialing, Business Operation, Excel Data Analysis, Data Analyst, and Lean Six Sigma Green Belt. Gained skills in various business and data analysis areas relevant to healthcare operations.

Rutgers University Certificate Program

Certificate Program, Management

2012 - 2016

Grade: Completed

Completed certificate programs focused on Senior Service Management and Strategic Planning. Training included Quality Analyst Auditor, Program Evaluation, and Managing Problem Behaviors.

Rutgers University

Certiﬁcate Program, Management, Training, and Program Evaluation

2012 - 2016

Grade: Completed

Completed a certificate program at Rutgers University. Focused on areas including Senior Service Management, Strategic Planning, Training & Development, Quality Analysis, Program Evaluation, and Managing Problem Behaviors. Developed skills in leadership, planning, and program assessment.