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340B Compliance/Credentialing Associate
I lead compliant 340B, credentialing, payer enrollment, and revenue cycle operations across complex healthcare networks.
United States340B Compliance/Credentialing Associate at Betances Health Center
Lead oversight of 340B Program operations and compliance, ensuring adherence to federal regulations. Direct end-to-end provider credentialing and enrollment across Medicare, Medicaid, and commercial payers, improving turnaround times and minimizing revenue delays.
340B ProgramCredentialingProvider EnrollmentMedicareMedicaidCommercial PayersData AnalysisExcelGoogle SheetsComplianceAudit ReadinessHIPAARecords ManagementForecastingCost Analysisperformance reporting
Associate's degree in Computer Programming & Information Systems.
Certificate in Medical Billing & Coding.
Provider Enrollment Specialist Certificate.
340B University OnDemand certification from Apexus.
HIPAA Compliance Certification.
Medical and Clinical Administration Certificate.
Managed high-volume ACT and HCBS claims operations across multiple payers, ensuring accurate processing and timely reimbursement. Conducted EOB analysis and denial trend identification, implementing corrective workflows to improve reimbursement accuracy.
Medical BillingClaims ProcessingEOB AnalysisDenial ManagementCernerAward recognitionNPINPPESHIPAAExcelData AnalysisComplianceAudit Readiness
Oversaw end-to-end revenue cycle operations for a high-volume claims unit, driving efficiency and accuracy with consistent throughput of 500+ daily claims. Developed training programs and SOPs across multiple billing platforms, reducing processing errors.
Revenue Cycle ManagementMedical BillingClaims ProcessingTrainingSOP DevelopmentData Analysisperformance reportingComplianceDenial ManagementProcess Improvement
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