Fifth Avenue Healthcare Services is excited this month to shine our Fifth Avenue Spotlight on Credentialing Director Jillian Davis, CPCS.
One look at her professional achievements will tell you that Jillian Davis seeks to improve any situation where she finds herself. Whether it be company policies and procedures or workflows that need improvement, Jillian will use every opportunity that comes her way to enhance any work environment she graces with her presence.
Even if a process doesn’t seem problematic at first glance, Jillian can still find ways to tweak it, streamlining it so that her colleagues can do their jobs more efficiently and accurately. It’s been said she’s a breath of fresh air to everyone she meets. With her inclination for innovation and development, this isn’t difficult to believe.
Being detail-oriented has undoubtedly helped her excel in the medical credentialing industry. Her in-depth knowledge of the NCQA (National Committee for Quality Assurance), URAC (Utilization Review Accreditation Commission), AAAHC (Accreditation Association for Ambulatory Health Care), CMS (Centers for Medicare & Medicaid Services), and other federal regulations enabled her to continue down a path of professional growth and success. Nearly ten years of hard work and dedication helped her craft her skills into what they are today.
Jillian Davis: The Beginning
Jillian Davis’ career began when she became a Client Service Coordinator and, later, a Center Manager for Meridian Business Centers. Here, she performed myriad administrative tasks that would also serve her well in the future. Auditing bills to find discrepancies before sending them to accounting helped her hone her attention to detail, an ability no credentialing expert can succeed without. Jillian was also responsible for creating and revising new procedures — just one more task that taught her lessons she’d take to subsequent positions.
Jillian Davis: Ongoing Expertise
In 2014, Jillian accepted the role of Credentialing Coordinator at CenseoHealth (now SignifyHealth). This company contracts with healthcare providers who make in-home visits for seniors to evaluate their health for Medicare Advantage plans. She performed the core duties of a credentialing specialist, such as obtaining all of the provider’s relevant documents and ensuring that they accurately completed their application. She verified the provider’s requirements for work approval when dealing with specific states and health plans.
Jillian also established and maintained a system that managed the timely processing of credentialing that observed NCQA standards.
She was promoted to Credentialing Manager at the same company, where her list of tasks and accomplishments grew. She developed workflow processes that scaled with increased business demands. This involved frequent audits identifying objectives and error rates, enabling her to help the credentialing department target its weaknesses and sustain higher efficiency.
Jillian Davis: More Triumphs
From there, Jillian accepted a new challenge: Credentialing Delegation Oversight Coordinator at Health Care Service Corporation with Blue Cross Blue Shield Texas.
In this new position, she conducted annual audits of credentialing policies and files of entities granted delegated credentialing functions on behalf of Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas. She worked with a Network Management team to review and improve delegation agreements. In addition, she developed auditing tools and department training manuals to serve her company’s credentialing team better.
In 2018, Jillian Davis obtained her CPCS (Certified Provider Credentialing Specialist) certification. Accomplishing this further proved her expert knowledge in credentialing, bolstering her professional reputation. This accomplishment helped raise her potential to advance in the industry, which she soon did.
Jillian followed up on this achievement when she joined Tenet Physician Resources. As their National Credentialing Manager, Jillian acted as a national liaison between her company, operations markets, and health plans to resolve any issues. She also maintained tight credentialing timeframes with health care practices and health plans, ensuring new physician onboards got added to Tenet National contracts by their start date. To help do so, Jillian created procedures to better update and maintain practitioner files for enrollment purposes.
She also worked with the National Director of Credentialing to help define departmental processes and execute strategic initiatives. Her other responsibilities included conducting delegation oversight reviews, audits of contracted health plans, and implementing corrective action plans established by these health plans and internal departments.
Jillian Davis’ Continued Achievements
All of her work at Tenet produced quantifiable results. In one year, she was able to accomplish credentialing delegation with 70% of contracted health plans.
Jillian soon sought new challenges. In 2021, Jillian Davis’ professional career took her to a new company where she could apply her extensive credentialing know-how. As the CVO Director of Operations for 5ACVO, Jillian guides the CVO operations and service team as they serve thousands of providers across the United States.
Jillian will use her considerable credentialing experience to help guarantee her team’s continued effectiveness and success. With nearly a decade of industry knowledge, Jillian Davis’ professional accomplishments will surely increase in the coming years.
More information about Fifth Avenue Healthcare Services
Fifth Avenue Healthcare Services is a NCQA Credentialing Accredited family of healthcare companies. Sister companies include 5ACVO (credentialing and primary source verification specialists), Fifth Avenue Agency (MPLI and medical malpractice insurance specialists), and Primoris Credentialing Network (credentialing and provider enrollment specialists with 54+ health plan and network provider enrollment options).
Fifth Avenue Healthcare Services originally published this article here. For information on Fifth Avenue Healthcare Services, please visit FifthAvenueHealthcareService.com or Contact Us.
