Janean Petrie
@janeanpetrie
Highly motivated Credentialing & Provider Enrollment Specialist.
United StatesWhat I'm looking for
I am a highly motivated Credentialing & Provider Enrollment Specialist with extensive experience in the full life cycle of provider credentialing. Over the years, I have successfully managed and overseen the delegated credentialing process, ensuring compliance with healthcare regulations and guidelines. My expertise lies in building strong relationships with providers and stakeholders, which has been instrumental in achieving organizational goals.
Throughout my career, I have coordinated all aspects of credentialing, privileging, and payer enrollment processes for behavioral and mental health providers. I have developed policies, applications, and verification forms tailored to the needs of the indigenous community, demonstrating my commitment to serving diverse populations. My attention to detail and problem-solving skills have allowed me to navigate complex credentialing challenges effectively, ensuring timely responses and resolutions.
Experience
Work history, roles, and key accomplishments
Credentialing & Provider Enrollment Specialist
Central Council of the Tlingit and Haida Indian Tribes of Al
Jul 2022 - Jan 2025 (2 years 6 months)
Coordinated all aspects of credentialing, privileging, and payer enrollment for behavioral and mental health providers. Developed policies and managed the delegated credentialing process while ensuring compliance with NCQA and federal guidelines.
Credentialing Team Lead
NMA (Neuromonitoring Associates)
Jan 2020 - Jul 2022 (2 years 6 months)
Managed the credentialing process for providers across multiple states, ensuring compliance with NCQA and state regulations. Coordinated onboarding and maintained accurate credentialing databases.
Credentialing Specialist
Harris County Public Health
Mar 2016 - Jan 2020 (3 years 10 months)
Managed physician and facility enrollment processes, ensuring compliance with NCQA and CMS guidelines. Collaborated with revenue cycle management to resolve billing issues.
Manager Credentialing/Provider Enrollment
ORION Health
Apr 2015 - Feb 2016 (10 months)
Oversaw the credentialing and provider enrollment process, ensuring timely onboarding of new providers. Managed interdepartmental communication to facilitate smooth hiring processes.
Delegated Credentialing & Provider Relations Manager
The University of Texas Health Science Center at Houston (UT
Feb 2000 - Apr 2015 (15 years 2 months)
Managed the delegated credentialing and payer enrollment process, ensuring compliance with industry standards. Developed policies and maintained relationships with internal and external stakeholders.
Education
Degrees, certifications, and relevant coursework
Monte Vista High School
High School Diploma, General Education
1983 - 1987
Completed high school education with a focus on general education subjects, preparing for further education and career opportunities.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Website
janeanpetrie.comJob categories
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