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- 1. 1 2 7 0 E A S T 5 1 S T S T R E E T • A P T . # 7 - D , B R O O K L Y N , N E W Y O R K 1 1 2 3 4 P H O N E 7 1 8 - 2 5 1 - 1 2 1 3 • E - M A I L S I D _ L E I D @ H O T M A I L . C O M SIDONIE LEID BJECTIVE To operate as a Provider Relations Specialist, utilizing my acquired training to effectively Analyze Credentialing Providers and related tasks. DUCATION COMPUTER CAREER CENTER, BROOKLYN NY Medical Office Technology/Billing Program ILLS XPERIENCE ne/2010 - present gust 11/09 – May 2010 Notary Public. Microsoft Office Suite, Microsoft office 365, Data Entry, Medical Terminology, CPT-4 Procedure Codes, ICD-9-CM Diagnosis Codes, Evaluation & Management Codes, Scheduling Appointments, CMS-1500 and Front Office, Fraud & abuse, HIPPA Requirements, HCPCS, Patient Status and History Information Forms, Medicaid, Medicare forms. NexGen and Cactus database. Symed OneApp Database. Advantage Care Physicians/Preferred Health Partners, Brooklyn, NY. – Credentialing Provider Relations Specialist Liaison to Physicians, Credentialing Vendors and Healthcare Insurance companies. Administrative functions for the Contracting and RCM department as directed by Manager. Meet and greet physicians and allied professionals. Create and modify documents using Microsoft Office, and maintain digitized signatures. Perform general administrative duties to include but not limited to: photocopying, faxing, mailing, and filing; maintain hard copy and electronic filing system, including scanning and filing documents into Scanned Images Folder. Correspond with hospital medical staff for active hospital privileges for physicians. Support Credentialing Vendor by obtaining provider documents as required. Assist with the processing of Administrative and Credentialing Vendor Reports. Set up and coordinate Contracting, Revenue Cycle, and Provider Relations meetings with Payers. Maintain proper documentation of licensure and certification for all medical staff in compliance with governmental rules and regulations. Coordinate the credential process for medical staff by verifying the credentials and generating the applications for reappointment and application for clinical privileges. Maintain current medical staff files along the guidelines of the accreditation standards. Maintain and update a database to identify medical staff members, types of appointment, and clinical privileges by department or division. Prepare and maintain related records and reports; collect relevant information related to medical staff reappointment and privileges. Experience with Intelli-Cred Healthcare Credentialing and NexGen Credentialing application. Verifications of New York State Education Department License, Office of Professional Medical Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs, & National Practitioner Data Bank; Verifications of New York State Education Department License, Office of Professional Medical Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs, National Practitioner Data Bank and Medicare Empire Services Opt-Out Manhattan Physician Group, NY, NY. – Credentialing Associate Maintain proper documentation of licensure and certification for all medical staff in compliance with governmental rules and regulations. Coordinate the credential process for medical staff by verifying the credentials and generating the applications for reappointment and application for clinical privileges. Maintain current medical staff files along the guidelines of the accreditation standards. Maintain and update a database to identify medical staff members, types of appointment, and clinical privileges by department or division. Prepare and maintain related records and reports; collect relevant information related to medical staff reappointment and privileges. Experience with Intelli-Cred Healthcare Credentialing and NexGen Credentialing application. Sidonie Leid Resume
- 2. b 2008-Aug 7/09 07 – 2008 04 - 2007 04-Internship 93-2003 91- 1993 91- 1991 80 - 1990 Verifications of New York State Education Department License, Office of Professional Medical Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs, & National Practitioner Data Bank; Assist with special projects as required Verifications of New York State Education Department License, Office of Professional Medical Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs, National Practitioner Data Bank and Medicare Empire Services Opt-Out Touchstone Health HMO – Credentialing Associate Processed initial & re-credential providers’ applications according to NCQA guidelines for participation in health plan, ensuring that they met the health plan criteria. Prepared all providers’ charts for presentation at monthly Credentialing Committee Meetings, checking license sanctions, malpractice history and par hospital privileges. Managed Medicare Opt-Out verifications; Verifications of New York State Education Department License, Office of Professional Medical Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs, & National Practitioner Data Bank. Inputted company information into Health Database. Updated providers’ demographics in Cactus database; Operated ABMs Board. Conducted follow up and phone/fax communications regarding status of applications and missing documentation; Assisted with special projects as required. Verifications of New York State Education Department License, Office of Professional Medical Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs, National Practitioner Data Bank and Medicare Empire Services Opt-Out Heavy phone and fax communication regarding status of applications and missing documents Saint Vincent Hospital – Patient Access Representative Worked in Emergency Room; Retrieved patient demographics and insurance; inputted data on (INVISION SMS) HDX system. Brookdale Hospital – Radiology Front Desk Clerk Prepared X-ray films for Radiologists to read; Answered phones; Prepared films for clinics. Hung up films in ICU for radiologists to read. Adult Day Health Care –Transportation Coordinator/Clerk Coordinated arrangements for elder registrants to Dr’s appointments; prepared charts & discharge charts; arranged round-trip transportation to program; answered phones. Completed medical billing on adhc software & by hand on 1500 forms. Brooklyn Hospital, Brooklyn - OB-GYN-Faculty Verified eligibility & insurance via telephone & internet; did Filing & demographics. Typed labels for patients’ charts; scheduled appointments for patients on Medical manager. Inputted diagnosis codes & procedures; checked claim status. Processed patients’ charts for billing. Fred Alger & Company Inc., Jersey City, NJ Maintained names, addresses, & account records of clients’ funds and transfers. Performed automatic data processing & inputted commission bills to OCS system. Interacted with traders and brokers; calculated brokers’ shares. Transferred funds and sent out dividends for the Phoenix in house program. Kidder Peabody, NY, NY - Data Entry Operator: IBM 3179. Housing Prevention Dept., Brooklyn, NY - Clerk Typist Answered telephones, responded to inquiries and maintained filing system. Shearson, Lehman, Hutton/American Express - Data Entry Operator Operated the D.O.T. System (Trading Floor); Liaison between Brokers & Specialists by preparing Day, Open & GTC orders. Wagner & Stott, Bear Stearns & Co. - Data Entry Operator Sidonie Leid Resume
- 3. REFERENCES FURNISHED UPON REQUEST. Sidonie Leid Resume