Nicole Bua

Nicole A. Bua 6725 W. Shade Lane #501 Wichita, KS 67212 -- Provider Credentialing Coordinator 10+ years of consistent performance in delivering optimal medical office management results Quick learner with an ability to grasp the latest trends by participating in technical meetings, seminars, & conferences and promoting professional growth through industry-wide collaboration. Comfortable working in varied healthcare settings and with personnel from different ethnicities & cultures. Team player with time management, organizational, problem-solving, decision-making, analytical, communication, and interpersonal skills. Excellent at adhering to the ethics of procedural impartiality, responsibility, and transparency for the evaluation of credentials to improve provider income while maintaining the highest level of patient care. Demonstrated capability in nurturing transformational relationships through provider-centric engagement tactics, ensuring correct provider data. Exceptional at leveraging state-of-the-art technology to streamline processes, deliver real-time information to patients & caregivers and improve productivity. AREAS OF PROFICIENCY • • • • • • Provider Credentialing Provider Enrollment Provider Data Management CAQH Organizational Development Multitask with Amazing Attention to Detail • • • • • • • Process Improvement Training & Development Information Confidentiality Recruitment & Retention HR Policies & Procedures Resources Optimization Provider / Employee Relations • • • • • • • Knowledge Sharing Project Management Competency Building Accounts Receivable OSHA Compliance Officer Work Comp Billing/Claims/Laws Planning & Scheduling TECHNICAL PROFICIENCY • CAQH, All Scripts RX Inventory, Microsoft Office, Google Docs/Google Drive, Google+ Local Expert, Google Analytics, Adobe CC CAREER ACHIEVEMENTS 75th & 126th Street Medical • Promoted specifically to accomplish a wide array of tasks such as ensuring that the company is kept abreast in terms of latest technology as well as recruitment needs and also to significantly augment annual profits with respect to both inventory and billing departments • Generated several thousand dollars in savings on a monthly basis by completely eliminating all locum tenens recruitment services and comprehensively training and ensuring participation in seminars of all medical billing personnel • Recouped over $64,000 from Medicare due to incorrect Provider Credentialing that took place prior to my employment. PROFESSIONAL WORK EXPERIENCE ProviDRs Care / WPPA, Wichita, KS, 2018 to Present Provider Relations • Plan strategies for recruitment, selection and retention of qualified Network Providers. • Recruit new providers the Network’s geographic service area. • Develop, contract, maintain and enhance relationships with providers and employer groups. • Problem solve network issues related to assigned provider service with internal staff. • Ensure policies and procedures to oversee contract performance and compliance are operating as required. • Works with leadership to identify network gaps and suggests additional providers for recruitment to ensure network adequacy. • Maintains provider data integrity including monitoring provider credentialing, location additions, demographic updates, and terminations. Trajectory Revenue Cycle Services, Wichita, KS, 2016 to Present Credentialing Coordinator • Built and Implemented Provider Credentialing Department from start to finish. • Provider Credentialing for 52 – 58 providers located at multiple primary care practices from Wichita to El Dorado as well as specialists including Orthopeadics, Hospitalists and Cardiologist. • Hospital Facility Contracts for a new Full Service Satellite Emergency Department opening 4/16/2018. • Cardiology Provider Based Billing including follow up, collection calls and front office support. Nicole A. Bua Page Two PROFESSIONAL WORK EXPERIENCE Continued Optometric Billing Solutions, Maize, KS, 2013 to 2016 Promoted to Transition Specialist, 2015 to 2016 Health Insurance Specialist, 2013 to 2015 • Assisted Providers with Credentialing Support • Meticulously monitor aging reports for assigned insurance carriers • Responsible for all EOBs, denials and rejected claims of assigned insurance carriers • Diligently evaluate, collect, and appeal any unpaid claims • Maintain a detailed record of all attempts in the relevant system software • Create and edit patient demographics as well as insurance related information • Check for updates and/or changes by regularly monitoring assigned insurance carriers • Process refund requests for assigned carriers • Handle preparation of medical records requested by assigned carriers • Manage the posting of insurance payments 75th Street Medical & 126th Street Medical, Ocean City, MD, 2005 to 2008 Promoted to Office Manager, 2007 to 2008 Administrative Assistant, 2005 to 2007 • Office Manager for both Urgent Care Centers Opened 24 Hours a Day from Memorial Day to Labor day located in Ocean City Maryland, a resort town. Normal office hours Labor day to Memorial Day. • Provider Credentialing for Surgeons and Doctors from different hospitals around the United States including John Hopkins & Walter Reed National Military Medical Center who provided service to our centers in the summers. • Improved both organization as well as team morale and productivity by cross-training and mentoring personnel into specific roles • Evaluated a wide range of prospective applicants by participating in all relevant job fairs, scanning 1000+ resumes annually and interviewing 100+ suitable candidates • Accomplished the recruitment, training & development of staff across 2 locations within a few weeks of the opening season in summer • Reworked trial days to achieve proper fitment for both the organization as well as the applicant by allowing the applicant to understand the process and gauge their comfort level with respect to the entire process • Handled upgrades of both software and hardware • Enhanced employee satisfaction and productivity through specific creative and cost-effective events, seminars for mentoring as well as contests • Diligently managed marketing projects such as the creation of brochures, business cards, photography and web design • Served on a need basis the role of a front desk, billing, appointments, and medical assistant on all days/shifts/holidays OTHER WORK EXPERIENCE • Office Manager, Action Sports Medicine & Pain Management, Plainview, NY, 2004 to 2005 • Maintained primary Physiatry office as well as 5 satellite physical therapy offices throughout New York. • Downtown Women OB/GYN, New York, NY, 1994 to 2004 • Top 3 Rated OB/GYN in Manhattan • Worked directly with Entity & Oracle to build a $300,000 personalized practice management software to save thousands of dollars a month in patient paper file storage. • Promoted to Patient Billing Manager, 2001 to 2004 • Administrative Assistant / Floater, 1994 to 2001 CERTIFICATION NAMSS Active Member since 11/7/2017 • CPCS Certification Scheduled for the Summer Testing Period June 23 – July 14, 2018 REFERENCES Derrick Idbeis, Owner – Trajectory RCS - Branda Barton, Owner - Optometric Billing Solutions - Suzanne La Joie, MD, Partner - Downtown Women OB/GYN -