At Mendota Health, I coordinated end-to-end provider enrollment and credentialing for multi-location medical groups using CAQH, PECOS, and NPPES. I supported provider readiness while helping prevent revenue disruption.
During rapid acquisitions, I supported credentialing for LPN, RN, MD, and NP providers and helped ensure new locations were compliant and ready for go-live.
I conducted primary source verification, resolved documentation errors, and managed payer contracting timelines. I also audited Medicare and Medicaid reimbursement applications to support complete enrollment documentation.
At Blue Cross Blue Shield, I executed initial and re-credentialing applications and audited provider licenses and certificates against NCQA requirements. I maintained credentialing data and tracking systems to support payer contracting and compliance monitoring.
