Latanya Mason
Perris
Summary
Healthcare professional specializing in provider enrollment and credentialing within complex environments. Successfully managed compliance and payer relations, driving revenue cycle efficiency and minimizing disruptions. Adept at coordinating enrollment activities and maintaining accurate provider records, ensuring timely processing and adherence to regulatory standards.
Overview
1
1
Certification
10
10
years of professional experience
Work History
Provider Credentialing Enrollment Specialist
Guardant Health
06.2022 - 03.2026
- Coordinated initial credentialing, recredentialing, and revalidation activities to prevent network disruptions.
- Supported provider enrollment and payer maintenance activities for Medicare, Medicaid, and commercial insurance plans.
- Maintained and attested provider profiles within CAQH ProView to support enrollment activities.
- Processed Medicare PECOS and NPPES updates to maintain provider participation.
- Coordinated collection and review of provider documentation for enrollment submissions to enhance submission accuracy.
- Tracked payer requests and monitored application statuses to ensure timely processing.
- Monitored renewal deadlines and participated in revalidation activities to maintain uninterrupted payer participation.
- Prepared reports and supported internal audits to ensure compliance with organizational policies and payer standards.
- Collaborated with credentialing, billing, and provider relations teams to resolve discrepancies affecting enrollment activities.
Senior Reimbursement Specialist - EDI
Guardant Health
03.2016 - 06.2022
- Managed EDI enrollment and maintenance activities, including electronic claims submission, Electronic Remittance Advice (ERA), and Electronic Funds Transfer (EFT) enrollments to support efficient reimbursement workflows.
- Monitored 837, 835, and payer acknowledgment reports, resolving transmission issues to ensure timely claims processing.
- Investigated reimbursement discrepancies and initiated appeals to maximize revenue recovery.
- Investigated reimbursement discrepancies and initiated appeals, enhancing revenue recovery efforts.
- Interpreted payer contracts, fee schedules, and reimbursement methodologies to ensure accurate payment expectations.
- Identified billing trends and root causes of denials and collaborated with cross-functional teams to implement corrective actions.
- Identified billing trends and root causes of denials, collaborating with cross-functional teams to implement corrective actions, improving claims resolution.
- Conducted claim audits to ensure compliance with federal regulations, payer guidelines, and organizational policies.
- Prepared and submitted reconsiderations, appeals, and supporting documentation for disputed claims.
Education
Associate of Arts - Liberal Arts (Psychology Emphasis)
Mission College
Santa Clara, CaliforniaSkills
- Provider enrollment
- Credentialing coordination
- Payer contracting
- Claims resolution
- Claim resolution
- Enrollment verification
- Claims processing
- Compliance auditing
- Reporting and analytics
- Claims data analysis
- Problem solving
- Time management
- Team collaboration
- Effective communication
Certification
- Certified Provider Credentialing Specialist (CPCS), NAMSS — In Progress | Expected 2026
- Certified Professional Coder (CPC), AAPC — In Progress | Expected 2026
- Electronic Health Record and Electronic Medical Record (EHR+EMR) Certificate, AAPC - In Progress | Expected 2026
- MACRA Proficiency Certifcate, AAPC - In Progress | Expected 2026
Timeline
Provider Credentialing Enrollment Specialist
Guardant Health
06.2022 - 03.2026
Senior Reimbursement Specialist - EDI
Guardant Health
03.2016 - 06.2022
Associate of Arts - Liberal Arts (Psychology Emphasis)
Mission College