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Description
The session is designed to bridge the gap between Credentialing/Enrollment and the Revenue Cycle by focusing on the most common causes of claims labeled as “credentialing issues” and how to resolve them efficiently. It’s a hands-on guide for clinicians, billing staff, and revenue cycle teams to improve claims accuracy and protect organizational revenue.
Learning Objectives
- Understand how credentialing and enrollment directly impact the revenue cycle
- Distinguish real credentialing issues from billing, registration, or system errors
- Apply a structured review process to “credentialing” claims
- Use standardized tools and checklists to resolve issues faster
- Improve cross-department communication and accountability.
Areas Covered
- Introduction & Context
- Credentialing vs. Enrollment vs. Billing
- Common “Credentialing” Claim Issues
- Practical Claim Review Framework
- Collaboration & Escalation Best Practices
- Wrap-Up & Key Takeaways
- Optional Tools / Handouts
Background
Credentialing with insurance companies is a crucial step for clinicians seeking to work in private practice or change their billing/work setting. Proper credentialing ensures that providers are recognized by insurance networks, can bill appropriately, and maintain compliance with industry standards. This session addresses common challenges and provides up-to-date guidance for providers. This reflects the need for healthcare teams to move beyond assumptions and silos, and instead adopt clear, structured processes and communication best practices that support the revenue cycle and reduce claim denials tied to credentialing and enrollment complexities.
Why Should You Attend
- Gain clarity on the credentialing and enrollment process
- Learn tips to avoid delays or errors in contracting with insurers
- Ensure your practice remains compliant and fully credentialed
- Access expert insights from an experienced industry professional.
Who Should Attend
- Revenue Cycle Staff (RCM/Billing Teams)
- Credentialing and Enrollment Teams
- Clinicians in Private Practice
- Practice Administrators / Office Managers
- Staff Transitioning Work/Billing Settings.
Speaker
Yesenia Servin is a nationally certified credentialing manager and provider enrollment specialist with over 27 years of experience in the healthcare industry. As an expert in credentialing and provider/payer enrollment, she has a deep understanding of Medicare & Medicaid enrollment.
Currently, Yesenia is the Director of Contracting, Credentialing & Provider Enrollment at United Vein & Vascular Centers. Through YS Credentialing PLLC, she assists organizations in developing and implementing best practices, guidelines, and processes, and guides the credentialing and payer enrollment structure.
Yesenia excels at training and mentoring administrative, credentialing, and enrollment healthcare professionals.
Her responsibilities include managing payer enrollment, keeping colleagues informed on industry trends, and serving as a liaison to all departments affecting payer-enrollment processes. She provides revenue cycle consulting services to various healthcare providers and organizations, including those focused on durable medical equipment, hospital and health systems, community mental health organizations, and global managed care organizations.
Yesenia is actively involved in professional and academic roles:
- Current Charter Oak University Faculty
- NAMSS member (and past NAMSS Educational Conference Guest Speaker)
- Current member of the NAHRI Leadership Council
- Current trainer for The Chicago School of Professional Psychology
- TMG Collaborator
She holds academic training in microeconomics and communications from NEIU and healthcare administration from Concordia University Chicago. In her personal time, Yesenia enjoys spending time with her family and pugs, and finds joy in trekking across the US states and regions.