Danielle Berrigan, CPCS

Experience

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  Oregon Eye Specialists, PC

  May 2013 - Jul 2022

  •Excelling in critical thinking, decisive judgement, and working with minimal supervision.•Coordinating, organizing, and maintaining the credentialing and re-credentialing process for practitioners. •Maintaining accurate provider rosters and credentialing databases (CAQH, NPPES, PECOS, Credential Stream, ECHO, Modio), attesting provider demographics, and maintaining confidentiality.•Ensuring timely completion of files, consistently following up with missing information or outstanding applications, conducting primary source verifications, and obtaining clinical activity documentation.•Ensuring that requisite licenses, malpractice coverage, and certifications are current.•Assisting in compliance with the accrediting and regulatory agencies (ie. Medical boards, NPDB, NCQA, CMS, TJC) while developing and maintaining a working knowledge of the statutes and laws.•Member of the leadership team; attending monthly meetings to discuss issues, trends, and assist in developing processes for improvement. •Supporting special projects and other assigned duties: °On-Call scheduling for physicians. °Collaborating, updating, and distributing a Community Ophthalmology ED/On-Call schedule comprised of three major Portland hospitals and two large, private-Ophthalmology practices. °Coordinating technician lectures for continuing education credit granted by JCAHPO. °Acting as a centralized surgery schedule coordinator. °EDI Enrollment-enrolling group practice in EFT and ERA transactions. °MIPS reporting-involved in coaching, tracking, coding, and quality improvement. °EHR & Coding Support- PM & Clinical: ModMed, MDOffice °Responding to medical record requests from patients, referring providers, and third parties. Show less •Knowledgeable in all aspects of billing including claim submissions, claims appeal, posting, accounts payable and accounts receivable.•General office management including oversight of clinical and non clinical staff, enhancing existing processes to maximize efficiency and practice flow and ensuring continuous quality improvement.•Monitoring staff are maintaining efficiency with patient registration and oversight of schedules to ensure patients are seen in a timely manner.•Training and supervision of front desk staff responsibilities including patient interaction, answering phones, documentation, collection of insurance, pre-approvals, referrals, and payments.•Monitoring practice expenses including office and medical supplies.•Maintaining updated documents, i.e. licenses, DEAs, credentialing. Show less

  • Credentialing Coordinator

    Jan 2018 - Jul 2022

  • Clinical Manager (Multiple Sites)

    Jan 2015 - Jan 2018

  • Certified Ophthalmic Assistant & Scribe

    May 2013 - Jan 2015
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  Willamette Dental Group

  Aug 2022 - now

  Credentialing Specialist

  •Coordinating, compiling, and maintaining the credentialing, re-credentialing, and enrollment process for practitioners.•Ensuring timely verification of credentialing and recredentialing applications by preparing requests for information, notification letters, tracking responses, responding to inquiries and following up for required information from practitioner.•Recognizing, investigating and validating discrepancies and adverse information obtained from applications, primary source verifications or other sources.•Maintaining credentialing database to ensure accurate and up-to-date data is available for practitioners, management, departments, and online directory profiles.•Auditing, assessing, procuring and implementing, effectively utilizing and maintaining practitioner credentialing processes and information systems by analyzing the needs and resources of the practice.•Assisting in compliance with the accrediting and regulatory agencies (ie. Dental boards, NPDB, NCQA, CMS) while developing and maintaining a working knowledge of the statutes and laws. Show less