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Skills

  • Employee relations
  • Supervision
  • Change Management
  • Vendor management
  • Method equipment
  • Organization
  • Compliance with Georgia Licensing Laws
  • Microsoft Office Suite proficiency
  • Training and mentoring
  • Team coordination

Work Experiences

  • Allowed the team to focus on complex cases.
  • Developed and implemented a credentialing checklist for new hires, improving compliance accuracy by 82%.
  • Instructed employees on how to use HR software, with a focus on the metric, framework, and metric features.
  • Conducted audits of provider files to ensure all certifications, licenses, and education verifications were active, preventing potential compliance issues.
  • Designed a successful provider resubmission program, leading to a 66% higher approval rate on previously denied applications.
  • Developed training materials on credentialing protocols.
  • Contributed to hospital staffing during the metric crisis.
  • Consistently met critical deadlines.
  • Decreased manual follow-up by 68%.
  • Achieved 69% first-time approval rates.

Summaries

  • Avoided penalties.
  • Achieved 26% first-time pass rates on applications.
  • Collaborated with HR and legal teams.
  • Conducted detailed process reviews.
  • Avoided potential revenue losses totaling $2.
  • Within Miscellaneous, senior Credentialing Assistant and outstanding performer in team leadership and client relations.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the initiative business.
  • Achieved a reduction of 39%.
  • Collaborated closely with providers and legal teams to facilitate urgent credentialing during the method crisis, verifying crucial qualifications for 13 new hires.

Accomplishments

  • Audited 18 credentialing files prior to regulatory review, leading to zero noncompliance findings.
  • Documented and resolved initiative which led to standard.
  • Supported management by preparing audits for credentialing compliance, resulting in a 52% reduction in audit findings.
  • Led efforts to transition from manual credentialing processes to ServiceNow, increasing processing efficiency by 27%.
  • Streamlined the provider review process, reducing credentialing timelines by 53% weeks.
  • Enhanced communication between the credentialing team and providers by implementing automated email alerts for expiring certifications.
  • Communicated effectively with providers and medical staff to resolve credentialing issues, decreasing provider onboarding time by 32%.
  • Successfully onboarded 16 physicians and clinical staff through detailed credentialing checks, enabling faster staff deployment.
  • Developed and implemented a tracking system for certification expiration dates, reducing delays in provider renewals by 32% days.
  • Ensured compliance with Georgia and national healthcare credentialing standards by regularly reviewing and updating files.

Affiliations

  • International Association of Administrative Professionals
  • National Association Medical Staff Services (NAMSS)
  • Health Care Administrators Association Membership
  • Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Compliance
  • Jaycees
  • American Marketing Association
  • American Society of Safety Professionals
  • Society of Human Resource Management
  • Credentialing and Enrollment Roundtable Discussions
  • Healthcare Financial Management Association (HFMA)

Certifications

  • Certified Professional in Healthcare Quality (CPHQ) by the National Association for Healthcare Quality (NAHQ)
  • Certified Documentation Improvement Practitioner (CDIP) by AHIMA
  • Certified HIPAA Professional (CHP) by Harbor & Co.
  • Certified Healthcare Professional (CHP) from American Institute of Healthcare Management
  • CompTIA Security+
  • Accredited Provider Enrollment Specialist (CPES) by NPE Association
  • CompTIA A+ Technician
  • SHRM Certified Professional (SHRM-CP)
  • Salesforce
  • Certificate in Credentialing, Licensing, and Privileging from process

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