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Skills

  • Supervision
  • Team collaboration
  • Document submission and approval
  • Business operations
  • Time management
  • Communication with healthcare professionals
  • Communications
  • Team management
  • Credentialing process management
  • Auditing credentialing records

Work Experiences

  • Contributed to achieving Excellence Award.
  • Achieved a 82% reduction in errors.
  • Kept meticulous records of office inventories and ordered additional supplies for $12.
  • Achieved results over a 8-month period.
  • Customer service, patient scheduling, and billing were among the duties I coordinated in the front office.
  • Collaborated with department leads.
  • Was in charge of patient scheduling, check-in, check-out, and billing payments.
  • Located, checked in, and pulled medical records for patient appointments and incomplete charts.
  • Collaborated with compliance teams to streamline credentialing audits, contributing to a 68% increase in regulatory adherence.
  • Achieved a 35% faster resolution rate.

Summaries

  • Adaptable and focused on reducing manual errors and improving overall accuracy and efficiency in credentialing processes by 28% through automation solutions.
  • Positive and upbeat personality with strong interpersonal communication skills.
  • Credentialing Associate is a multi-talented Credentialing Associate who is consistently rewarded for planning and operational improvements.
  • Costs were consistently reduced while profits were increased.
  • Goal-oriented and friendly, with a track record of updating traditional offices to improve patient satisfaction.
  • Credentialing Associate with 6 years of experience in metric industry is meticulous.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Achieved a 83% reduction in application backlogs.
  • Exceptional attention to detail, collaboration, and typing skills.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.

Accomplishments

  • Successfully completed credentialing audits for 2 providers, resulting in 82% adherence to compliance guidelines.
  • Processed an average of 13 enrollment applications per week, ensuring complete and accurate submission to relevant entities.
  • Collaborated with team of 3 in the development of method.
  • Maintained compliance with NCQA and URAC standards, ensuring timely submission for 9 credentialing applications.
  • Trained new hires on credentialing procedures, improving team productivity by 34% and reducing errors by 14 reports per month.
  • Documented and resolved metric which led to framework.
  • Developed relationships with external credentialing verification organizations, speeding up approval processes by 5 weeks.
  • Developed internal reporting structures that tracked the lifecycle of each credentialing case, improving accountability within the department.
  • Scheduled and facilitated trainings for 9 credentialing associates on systems and compliance protocols, improving accuracy and team confidence.
  • Revised provider outreach communication templates, resulting in a 37% improvement in response rates and faster submission times.

Affiliations

  • American College of Healthcare Executives (ACHE)
  • National Association of Social Workers
  • Council for Nonprofit Credentialing Professionals (CNPP)
  • Coalition for Seamless Credentialing
  • Association for Computing Machinery
  • American Board of Quality Assurance and Utilization Review Physicians (ABQAURP)
  • American Marketing Association
  • Association of Independent Doctors (AID)
  • Institute for Credentialing Excellence (ICE)
  • Council on Ethical and Judicial Affairs (CEJA)

Certifications

  • Certified Provider Credentialing Specialist (CPCS) - method
  • Project Management Professional (PMP) – Project Management Institute (PMI)
  • Cisco Certified Network Associate (CCNA)
  • Credentialing Boot Camp - Northwind
  • Certified Medical Practice Executive (CMPE) from the American College of Medical Practice Executives (ACMPE)
  • Certified Public Accountant (CPA)
  • Health Information Technology for Economic and Clinical Health (HITECH) Specialist
  • Certified Medical Staff Coordinator (CMSC)
  • Cisco Certified Internetwork Expert (CCIE)
  • Medical Auditing Certification – AAPC (or approved institution)

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