Deanna K. Francis
954-397-1237
OBJECTIVE
I am seeking a career and a challenging position with a healthcare organization that will utilize and encourage development of my healthcare support skills.
EXPERIENCE
TeamHealth Tamarac, FL September 2018 - Present
Team Lead - Credentialing Specialist
• Medical staffing for Acute and Post Acute Care.
• Medical license, certificate, and DEA renewal for medical professionals.
• Review and report credentialing and licensing issues to Regional Medical Director/VP Nursing.
• Running pending privilege reports and delegate amongst team.
• Verifications of provider credentials for internal processing.
• Assist with new start-ups and integrations.
• Liaison between provider and medical staffing office.
• Assist with medical staffing requests for committee, credentials, and board meetings.
• Maintain credentials in credentialing system.
• Floater. Assisting team members with credentialing reports and trending issues.
• Manage credentialing data and process reports to update management and medical staff.
Dr. Joan Lyn, DO North Miami, Florida June 2012 – Present
Coding Specialist – Part Time
• ProFee Coding (Family and Internal Medicine, Pain management, OBGYN)
• Medical Record review to assign appropriate procedure and diagnosis code.
• Transmission of medical claims
• Correct coding and billing errors for resubmission.
SBG Healthcare Davie, Florida October 2017 – July 2018
Credentialing Specialist
• Medical license renewal for medical professionals
• Enroll providers with commercial and government plans.
• Onboarding and verifications of provider credentials for internal processing.
• Complete Run Loss and Claims history requests.
• Assist with medical staffing requests for committee meetings.
• Follow up and maintain of provider reappointments, and licensure renewals.
• Assist management with effective processes to increase quarterly audits.
• Assist Director with implementing new system for maintenance for credentialing.
Sheridan Healthcare Sunrise, Florida July 2014 – July 2017
Lead Credentialing / Provider Enrollment Coordinator
• Medical license renewal for medical professionals
• Enroll providers with commercial and government plans.
• Maintenance of provider file in credentialing system: Evips/Vistar
• Coordinate travel, lodging, car rental for provider.
• Follow up and maintain provider re-credentialing and license renewals.
• Conduct weekly team meetings to discuss enrollment issues and productivity.
• Train new employees on system, productivity measures, policies and procedures.
• Manage and report team productivity to management.
• Enroll physicians with several groups for new startups and acquisitions.
• Collaborate with integrations team to assist with staffing needs for new groups and providers.
• Enroll medical group of 50 physicians or more with all government plans.
• Provide effective ideas to help assist providers with applications.
• Process Improvement/Kaizen leader for new office equipment.
• Process Improvement/Kaizen member for new policy and procedure for department.
Sheridan Healthcare Sunrise, Florida November 2013 - July 2014
Lead Billing / Reimbursement Specialist
• Supervise and support medical collections team with billing and collections.
• Assist team with medical Insurance verification.
• Audit and review of unpayable and high dollar claims for adjustment.
• Review of charges entered into billing system by team.
• Research denial issues of un-paid claims for management.
• Develop action plan to correct payable claims with management.
• Post payments and apply recoupments.
• Keep meeting minutes for managements meetings.
• Report trending issues to management
• Complete coding and corrected claims according to coding guidelines.
• Patient collections on non-covered charges, copays, deductibles, and coinsurances.
• Complete adjustments and balance write offs.
• Liaison between provider enrollment and insurance plan.
• Assist in company Kaizen for process improvements of collections and correspondences.
• Research and report trending issues to management.
• Conduct weekly and monthly meetings for work improvements and revenue updates.
• Run monthly report for management staff.
• Communicate fee schedule and contracting updates amongst team.
• Communicate coding issues to management and direct team members with management’s approval.
PRRS - Professional Revenue Recovery Solutions Sunrise, Florida September 2012 – November 2013
Lead Collector - Quality Analyst
• Review medical collections reports for laboratory and substance abuse treatment facilities.
• Train new staff on substance abuse collections and EMR system.
• Enter charges for claims transmission via Medisoft and other various billing systems.
• Audited coder records for production and correct coding according to audit plan.
• Assist management with creating billing and coding p...
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