7 Urgent Processes of a Successful Credentialing/Enrollment Leader

The need for knowledgeable, solution-focused provider/payer enrollment experts is great. In order to successfully complete payer credentialing/provider enrollment, follow the right path and timeline, every time. In Provider Enrollment, we must successfully and continuously maintain multiple provider profiles, including CAQH, I&A, NPPES, PECOS, Directories, Network portals, etc. Any missing piece in the cycle can negatively impact the provider’s network participation and the organization’s revenue cycle. This session will identify and review the urgent processes that you need to implement and manage in your organization.

Learning Objective

• Identify all the provider and payer portals that are needed in your role
• Identify how to manage your enrollment timelines and your team’s timelines easily
• Review the urgent process that you need to implement and maintain in your organization
• Implement project management tools that will increase efficiency and improve team communication

Areas Covered in the Session:

• Government Payers & Private (Commercial) Networks
• PE Timeline Policies
• Provider Portals
• Payer Portals
• On-boarding new providers and Off-boarding providers
• Required Soft Skills
• Project Management

Suggested Attendees

• Practice Managers
• Healthcare Billing Specialist
• Staff providing NPI support, NPPES support
• PESC, CPMSM, CPCS
• Staff providing CAQH support
• Clinic Managers
• Allied Health Providers
• Advance Health Practitioner
• Credentialing
• Enrollment
• Office Managers
• Operations
• Revenue Cycle
• Coders
• Clinical Directors
• Practice Owners
• Claims Teams
• MSPs

About the Presenter

Yesenia Servin is an expert in credentialing and provider/payer enrollment with 22 years of experience in the healthcare industry. Yesenia has a deep understanding of Medicare & Medicaid enrollment and is a nationally certified credentialing manager and provider enrollment specialist. Through, YS Credentialing PLLC, Yesenia

• Helps organizations develop and implement best practices guidelines and processes
• Analyzes revenue cycle management
• Guides the credentialing and payer enrollment structure

Yesenia is the payer enrollment lead with TeamMed Global. She manages payer enrollment, keeps team members up to date on industry trends, and is a liaison to all departments that impact payer-enrollment processes. In previous positions, Yesenia has worked with durable medical equipment, hospital and health systems, and community mental health organizations, global managed care organizations as well as providing revenue cycle consulting services to various healthcare providers and organizations.

Yesenia is a current Team Med Global Lead Collaborator, Team Med Global University Faculty, NAMSS member, and is a current and past NAMSS Educational Conference Guest Speaker, a current member of the NAHRI Leadership Council, current trainer for The Chicago School of Professional Psychology and industry trainer. Yesenia studied microeconomics and communications at NEIU and is currently studying healthcare administration at Concordia University Chicago.