Vicki Miles
Byram
Summary
Efficient and detail-focused professional with a strong background in various roles, demonstrating advanced communication and people skills. Adept at quickly learning new tasks and committed to timeliness and reliability. Ready to contribute effectively to team success and organizational goals.
Seasoned credentialing specialist lends several years of success overseeing complex information access policies and procedures. Effective documentation and management to maintain threshold requirements. Detail-oriented processing for status-change requests and assessments. Hands-on approach to handling requests-for-access and information credentialing.
Overview
18
18
years of professional experience
Work History
Credentialing Specialist
Community Health Systems, CHS
Franklin
12.2024 - Current
- Verified provider credentials and maintained accurate documentation for compliance.
- Coordinated with medical staff to gather necessary application materials.
- Facilitates the pre-filling; sending and receiving of accurate and complete credentialing information; tracks and reports progress and performs follow-up activities as needed until provider file is complete and a provider is awarded privileges.
- Reviews the documents collected during on boarding to confirm they made state federal and hospital partner requirements to include a current state license, CSR (if required), and DEA certificates to practice in contracted states.
- Validates and verifies data entered in the credentialing database to ensure accurate and comprehensive.
- Partners with credentialing leadership to ensure successful launches of new accounts in assigned territory.
- Ensures timely issue of COI and enrollment in any state patient compensation funds through completion of the insurance application for all assigned providers.
- Prepares and submits state collaborative documentation for advanced practitioners and ensures, continuous compliance with the state.
- Coordinates the license, CSR, and DEA request with the third-party service and monitors from initiating the request to issuance of the credentials.
- Escalate concerns regarding the licensing, state, collaborative, and privileging a providers and non-response to management.
Medical Staff Credentialing Specialist
Merit Health Market / CHS
Flowood
01.2020 - Current
- Maintain credentialing files for all active medical staff, ensuring compliance and accuracy.
- Conduct thorough background investigations, enhancing the reliability of credentialing.
- Prepare and present applicant credentials files, streamlining the onboarding process.
- Organize new practitioner orientation, improving integration and readiness.
- Manage Contractor Portal database for non-staff providers, maintaining up-to-date records.
- Prepare verification letters and maintain provider database, ensuring data integrity.
- Initiate contact with medical office staff, licensing agencies, and insurance carriers, facilitating the credentialing process.
- Maintain provider files and respond to credentialing requests, supporting inter-entity collaboration.
- Generate monthly exclusion check reports for Corporate Compliance, ensuring regulatory adherence.
Administrative Assistant
Merit Health Central / CHS
Jackson
01.2015 - 01.2020
- Fielded and screened executive office calls, ensuring efficient communication flow.
- Directed visitors and managed executive calendars, optimizing schedules and meeting coordination.
- Performed administrative duties, supporting executive management with high-level tasks.
- Arranged travel and prepared site visit agendas, enhancing recruitment processes.
- Collected data and prepared monthly audits, contributing to compliance meeting presentations.
- Recorded and transcribed meeting minutes, ensuring accurate documentation for corporate office.
Medical Secretary
Premier Medical Group
Jackson
01.2011 - 01.2015
- Scheduled and confirmed patient appointments, surgeries, and consultations, ensuring smooth operations.
- Routed laboratory results and important documents to physicians, enhancing communication efficiency.
- Prepared correspondence and reports for healthcare providers, maintaining accurate documentation.
Billing Specialist
Jackson Radiology
Jackson
01.2008 - 01.2011
- Collected and batched physician charges daily, streamlining billing processes.
- Coordinated outside referrals and maintained hospital lists for physician rounds, improving patient care.
- Resolved patient billing complaints, leading to improved patient satisfaction and streamlined processes.
- Prepared and sent patient statements, ensuring timely and accurate billing communications.
- Assisted patients with payment plans, enhancing affordability and reducing outstanding balances.
- Investigated delinquent accounts, providing detailed reports and facilitating collections.
- Submitted and audited insurance claims, increasing approval rates and reducing denials.
Education
Course Study - Business Administration
Hinds Community College
Pearl, MSHigh School Diploma -
Brandon High School
Brandon, MSSkills
- Time Management
- Customer Service
- Organizational Skills
- Multitasking
- Attention to Detail
- Interpersonal Skills
- Adaptability
- Onboarding
- Credential verification
- Compliance documentation
- Data accuracy
- Provider onboarding
- Medical staff coordination
- Database management
- Inter-entity communication
- Attention to detail
- Effective communication
- Time management
- License verifications
Timeline
Credentialing Specialist
Community Health Systems, CHS
12.2024 - Current
Medical Staff Credentialing Specialist
Merit Health Market / CHS
01.2020 - Current
Administrative Assistant
Merit Health Central / CHS
01.2015 - 01.2020
Medical Secretary
Premier Medical Group
01.2011 - 01.2015
Billing Specialist
Jackson Radiology
01.2008 - 01.2011
Course Study - Business Administration
Hinds Community College
High School Diploma -
Brandon High School
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