Amy Saar
Jersey Shore
Summary
Dynamic Credentialing Specialist with extensive experience at UPMC Williamsport, excelling in provider communication and credentialing documentation. Proven track record in ensuring compliance and timely processing of applications, enhancing operational efficiency. Adept at multitasking and maintaining meticulous records, contributing to improved service delivery in healthcare settings.
Overview
30
30
years of professional experience
Work History
Credentialing Specialist
UPMC Williamsport
Williamsport
10.2021 - Current
- Conducted thorough background checks and verified educational and professional qualifications.
- Maintained up-to-date records of credentialing statuses in database systems.
- Provided support in responding to inquiries from external parties regarding credentialing information.
- Facilitated communication between departments to resolve credentialing issues efficiently.
- Coordinated with healthcare professionals to collect necessary documentation for credentialing.
- Managed end-to-end provider credentialing process, ensuring compliance with industry standards.
- Ensured timely completion of credentialing processes by providing guidance to providers on required documentation.
- Processed re-credentialing applications for existing providers according to contractual requirements.
- Participated in credentialing committees, presenting cases and making recommendations.
Medical Billing Assistant
River Valley Health and Dental Center
Williamsport
05.2020 - 10.2022
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Identified potential coding issues that could lead to denials or underpayments and addressed these issues promptly.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Applied HIPAA privacy and security regulations while handling patient information.
- Assisted patients in understanding the details of their billings and payments.
- Handled billing, waivers and claims for private and commercial clients.
- Reconciled account balances when necessary due to incorrect payments or rejections from payers.
- Maintained accurate records of claims processing in compliance with HIPAA regulations.
- Collected, posted and managed patient account payments.
- Performed follow-up on unpaid or rejected claims with insurance providers.
- Submitted claims to insurance companies.
- Verified insurance coverage and eligibility for medical services rendered.
- Provided customer service support to patients over the phone related to billing questions or concerns.
Surgical Scheduler
Mount Nittany Physician Group
State College
12.2018 - 05.2020
- Schedule diagnostic testing and surgeries for 8 providers in office.
- Obtain any authorizations needed, make and change appointments, referrals
- Performed data entry into various computer systems related to surgical scheduling activities.
- Conveyed information to patients about arrival times and preoperative procedures.
- Processed pre-operative orders including lab work, imaging studies and any other required tests prior to surgery date.
- Provided assistance with post-operative follow up visits when needed.
- Verified insurance eligibility and coverage prior to surgery.
- Worked with operating facilities to schedule procedures on behalf of surgeons.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
Credentialing Specialist/Coverage and Auth Specialist
Community Services Group, Inc.
Williamsport
10.2016 - 12.2018
- Do new and established physicians and therapists credentialing and recredentialing, check insurance, and obtain authorizations for services needed for clients?
- Maintained up-to-date records of credentialing statuses in database systems.
- Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
- Provided support in responding to inquiries from external parties regarding credentialing information.
- Responded to verification inquiries from other healthcare organizations and insurance companies.
- Processed re-credentialing applications for existing providers according to contractual requirements.
Medical Secretary/Administrative Assistant
Lock Haven Medical Center
Lock Haven
04.2007 - 10.2016
- Medical billing and account receivables
- Schedule patients for appointments and tests
- Medical and pharmaceutical prior authorizations
- Chart reviews
- Order supplies
Medical Secretary
Lycoming Internal Medicine
Jersey Shore
04.1995 - 06.1998
- Medical billing
- Account receivables
- Schedule appointments and referrals
- Medical and pharmaceutical prior authorizations
- Chart reviews
- Order supplies
Education
General -
Jersey Shore Area High School
Jersey Shore, PA06.1985
Skills
- Customer service
- Provider communication
- Scheduling
- Medical Terminology
- Medical Billing
- Claims processing
- Time management
- Data entry
- Medical billing
- Multitasking Abilities
- Time management abilities
- Credentialing documentation
- Attention to detail
- Adaptability and flexibility
Timeline
Credentialing Specialist
UPMC Williamsport
10.2021 - Current
Medical Billing Assistant
River Valley Health and Dental Center
05.2020 - 10.2022
Surgical Scheduler
Mount Nittany Physician Group
12.2018 - 05.2020
Credentialing Specialist/Coverage and Auth Specialist
Community Services Group, Inc.
10.2016 - 12.2018
Medical Secretary/Administrative Assistant
Lock Haven Medical Center
04.2007 - 10.2016
Medical Secretary
Lycoming Internal Medicine
04.1995 - 06.1998
General -
Jersey Shore Area High School
Similar Profiles
Nicholas BeiterNicholas Beiter
Food Service Host at UPMC WilliamsportFood Service Host at UPMC Williamsport
Patrick LacherPatrick Lacher
Phlebotomist at UPMC WilliamsportPhlebotomist at UPMC Williamsport
Jodeci ChasenJodeci Chasen
Phlebotomist at UPMC Williamsport HospitalPhlebotomist at UPMC Williamsport Hospital