I have eight years of experience in the medical credentialing and medical billing fields. I have extensive knowledge credentialing groups, providers, and non-physician practitioners in Michigan, Washington, Oregon and Nevada. My medical billing knowledge includes family practice and urgent care billing in Michigan and dermatology in Florida.

I am a current member of the AAPC, earning my certification as a Certified Professional Biller in 2019.

Areas of Expertise

• Credentialing and contracting medical groups, physicians, and non-physician practitioners

• Quarterly demographic attestations

• Tracking and notifying providers of expiring credentials

• Direct source verification

• Fee schedule review and negotiations

• Posting insurance and patient payments – EFT and paper

• Recovery of rejected and unresolved claims

• Collections of past due patient accounts and/or establishing payment plans

• Patient and payer refunds/overpayment notifications

• Submitting primary, secondary and teritiary electronic and paper claims

• Downloading ERA’s / pulling EOB’s from payer sites

• Enrolling in EFT for rapid payer payments

• Preparing reports for patient population data, refunds, & collections activity

• Eligibility and benefit verification

• Coordination of benefits corrections

Payer & Entity Knowledge

• Aetna

• OptumCare Network

• Blue Care Network

• Blue Cross Blue Shield

• Cigna

• Humana

• Humana Military / Tricare

• Medicare and Medicaid, including managed care plans

• Priority Health

• Regence

• Amerigroup

• Premera

• SilverSummit

• PacificSource

• Wellcare

• United Healthcare

• Workman’s Comp

• CAQH

• ProviderSource