Hello! I am a Medical Credentialing and Revenue Cycle Management (RCM) Specialist with over 3 years of experience supporting behavioral health and medical practices across the United States.
My primary expertise is provider credentialing and payer enrollment, including initial credentialing, recredentialing, CAQH profile setup and maintenance, insurance panel enrollments, provider directory updates, EFT/ERA enrollment, and tracking application statuses from submission through approval. I am experienced in gathering and organizing credentialing documents such as W-9s, liability insurance, state licenses, DEA certificates, and IRS CP575 letters to ensure applications are complete and processed efficiently.
I have worked with commercial and government payers including Aetna, Cigna, Optum/UHC, BCBS, Medicare, Medicaid, and TRICARE/TriWest. I am also experienced in communicating directly with payer representatives to resolve credentialing delays, enrollment issues, and claim-related concerns.
In addition to credentialing, I have strong experience in medical billing and front-end RCM processes, including eligibility and benefits verification, prior authorizations, denial management, claim follow-up, appeals, accounts receivable management, patient intake coordination, and scheduling support.
I am proficient in using EHR/EMR platforms such as SimplePractice and CharmHealth, along with payer portals including Availity, CAQH, and Optum. I am highly detail-oriented, organized, and committed to helping practices streamline their operations, maintain compliance, and maximize reimbursements.
I am always open to long-term collaborations and opportunities to support growing practices with credentialing and RCM needs. Let’s connect!
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