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Course Description

Integrating payer enrollment and credentialing functions continues to gain momentum as consolidation efforts and mergers and acquisitions exponentially increase. Join Team Med Global’s Donna Goestenkors, CPMSM, EMSP and Yesenia Servin, CPMSM, PESC in exploring the implications of this new frontier, and get up to speed on understanding the big picture and nuances of credentialing and payer enrollment.

Learning Objectives:

  1. Explain the parallels between payer enrollment and credentialing processes.
  2. Identify transferrable skills between these two areas of specialty.
  3. Describe the benefits of payer enrollment and credentialing collaboration.
  4. List the core process steps involved in credentialing and payer enrollment.

Areas Covered in the Session:

  • Outline the tasks in common between payer enrollment and credentialing
    – Compliance
    – Application Management
    – Communication Skills
    – Technology Management
    – Relationship Building
    – Deadlines
  • Introduce the core competencies required in each of these functions
    – Presentation of Executive MSP Core Competency Model
    – The Payer Enrollment Competency Model
  • Collaborating aligns thought, expectations, accountabilities and problem solving.
  • Introduce the Payer Enrollment Process Model

Suggested Attendees:

  • Medical Staff Services Professionals (MSPs)
  • Payer Enrollment Professionals
  • Healthcare Administration
  • Practice Management Administrators
  • Revenue Cycle Managers

About The Speaker:

Donna Goestenkors, CPMSM, EMSP is a healthcare consultant, speaker, author, educator, and mentor with over 44 years of knowledge and experience that she is privileged to share with colleagues, healthcare administrators and medical staff leaders on issues pertinent to the medical staff services industry. Donna is the founder and president of Team Med Global, and is an industry thought leader who serves professionals by delivering educational products, services, and resources. Donna is also a past president of the National Association Medical Staff Services (NAMSS), and has been actively engaged in several domestic and international credentialing think tanks. Her diverse expertise is relevant to all healthcare l environments, including coast to coast, system, academic, community and critical access hospitals, credentials verification organizations, payer enrollment, managed care organizations, and group and solo practice settings. Her talent in leading medical services professionals (MSPs) to their greatest level of competence garners Donna great respect among her colleagues within the industry.

Donna has authored, co-authored, and contributed to numerous articles and books. In addition, Donna speaks frequently on healthcare issues at in-person and virtual conferences and symposia. Donna earned her associate degree in Medical Services from Kansas City Business College, holds certification in Medical Staff Services Management (CPMSM) through NAMSS, and achieved her Executive MSP (EMSP) credential through TMG University. She graduated from an intensive training program at the Speaker’s Academy presented through Brian Tracy International and recently completed a nine-month virtual leadership course, Platinum Series, through Nightingale Conant Corporation.

Yesenia Servin, CPMSM, PESC, manages payer enrollment for the Loyola University Health System in Maywood, IL. In addition to managing payer enrollment, she briefs payer enrollment team members on industry trends and is the liaison for the multitude of departments impacting payer enrollment processes.

Yesenia also maintains her own consultancy, YS Credentialing LLC, in which she guides organizations in developing and implementing best practice guidelines and processes; analyzes revenue cycle management; and formulates credentialing and payer enrollment structures.

With over 22 years in the healthcare industry, Yesenia’s experience includes government payers, commercial/private payers, durable medical equipment, hospital and health systems, community mental health organizations, global managed care, and other healthcare providers and organizations. Yesenia is a current Team Med Global collaborator, TMG University faculty member, NAHRI Leadership Gold member, and NAMSS member. She is a past NAMSS Educational Conference guest speaker and current trainer for The Chicago School of Professional Psychology. She studied microeconomics and communications at Northeastern Illinois University, and is currently studying healthcare administration at Concordia University Chicago.

 

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