Kaley Davis
Hoschton
Summary
Detail oriented Provider Enrollment Associate with experience managing provider credentialing, payer enrollments, roster management and healthcare compliance. Skilled in CAQH, Medallion, NPI enrollment, payer portals and provider data management. Recognized for strong organization, accuracy, problem solving and the ability to manage multiple priorities in a fast paced remote environment.
Overview
9
9
years of professional experience
Work History
Provider Enrollment Associate
Geode Health
Remote
08.2023 - Current
- Manage provider enrollment and credentialing for multiple commercial and government payers.
- Process initial enrollments, revalidation, terminations and demographic updates.
- Maintain provider data using CAQH, Medallion, NPI Registry and payer portals.
- Submit and track applications to ensure timely payer approval.
- Coordinate credentialing delegation activities and roster submissions.
- Investigate enrollment issues and resolve payer denials.
- Collaborate with internal departments to ensure accurate provider information and minimize delays.
- Manage multiple projects simultaneously while meeting strict deadlines.
- Serve as the primary coordinator for Emory CIN provider onboarding, ensuring all credentialing, enrollment, background screening and required documentation are completed accurately and on time.
Office Manager
Netclaims Medical Management, LLC
Hoschton, GA
07.2017 - 11.2022
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Coordinated benefit processing, including enrollments, terminations and claims.
- Reviewed employee enrollments to verify accuracy, inputting information into company database.
- Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
- Performed quality control of data entry system to verify proper posting of claims and payments.
- Oversaw key customer relationships to close strategic opportunities.
Education
High School Diploma -
Mountain View High School
Lawrenceville, GASkills
- Credentialing Management
- Enrollment Systems
- Healthcare Software
- Payer Portals
- Roster Management
- Quality Assurance
- Process Improvement
- Microsoft Excel
- Microsoft Office
- Problem Solving
- Time Management
- Cross-functional Collaboration
- Written & Verbal Communication
- Collaboration
Timeline
Provider Enrollment Associate
Geode Health
08.2023 - Current
Office Manager
Netclaims Medical Management, LLC
07.2017 - 11.2022
High School Diploma -
Mountain View High School