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Skills

  • HIPAA compliance
  • Time management
  • Accuracy in documentation review
  • Business operations
  • Auditing credentialing records
  • Workflow Optimization
  • Team management
  • Internal audits for compliance
  • Lean process methodologies
  • Process automation

Work Experiences

  • Achieved a 35% faster resolution rate.
  • Achieved a 33% increase in first-pass approvals.
  • Improved bill payment timeliness by developing flexible payment plans for patients.
  • Collaborated with compliance teams.
  • Was in charge of patient scheduling, check-in, check-out, and billing payments.
  • Conducted inspections in 2020.
  • Kept meticulous records of office inventories and ordered additional supplies for $12.
  • Achieved a 82% reduction in errors.
  • Achieved a 44% cost reduction in administrative processing.
  • Decreased onboarding delays by 2 weeks.

Summaries

  • Exceptional attention to detail, collaboration, and typing skills.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Dedicated to streamlining organizational procedures in order to improve office environments.
  • Healthcare practices, compliance standards, and operations are all familiar territory for this versatile administrative professional.
  • Achieved a satisfaction rate of 22%.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the metric business.
  • Credentialing Associate is a well-organized Credentialing Associate who is well-versed in healthcare processes and administrative requirements.
  • Achieved faster resolution rates.
  • Goal-oriented and friendly, with a track record of updating traditional offices to improve patient satisfaction.
  • Achieved a 68% improvement in credentialing accuracy.

Accomplishments

  • Handled an average of 13 credentialing inquiries per week, delivering consistently high customer satisfaction scores.
  • Used Lean methodology principles to re-engineer credentialing workflows, resulting in 36% improved efficiency and lower administrative costs.
  • Supported the credentialing and re-credentialing of 8 healthcare professionals within established SLAs, ensuring 100% compliance with payer requirements.
  • Collaborated with team of 3 in the development of method.
  • Resolved 14 credentialing disputes between providers and insurance companies, achieving a 67% first-time resolution rate.
  • Resolved product issue through consumer testing.
  • Reviewed and validated applicant information for Jira usage background, reducing rejection rate by 68%.
  • Updated and maintained accurate credentialing records for 8 providers, ensuring timely renewals and payer acceptance.
  • Led a process improvement initiative that reduced credential verification times by 7 days, enhancing provider satisfaction ratings by 72%.
  • Developed relationships with external credentialing verification organizations, speeding up approval processes by 5 weeks.

Affiliations

  • International Association of Administrative Professionals
  • Lions Club
  • National Commission for Certification of CME Professionals (NC-CME)
  • Credentialing Resource Center (CRC) Membership
  • Institute for Credentialing Excellence (ICE)
  • Association of Independent Doctors (AID)
  • American Marketing Association
  • Certified Professional Medical Staff Management (CPMSM)
  • National Association of Medical Staff Services (NAMSS)
  • Association of American Physicians and Surgeons (AAPS)

Certifications

  • Medical Auditing Certification – AAPC (or approved institution)
  • Certified Professional Medical Services Management (CPMSM) - standard
  • ServSafe
  • Certified Public Accountant (CPA)
  • Licensed Health Insurance Agent – Certification process
  • Certified Professional in Healthcare Quality (CPHQ)
  • Salesforce
  • Cisco Certified Network Associate (CCNA)
  • Certified Medical Practice Executive (CMPE) from the American College of Medical Practice Executives (ACMPE)
  • Accreditation Preparation Workshop - Joint Commission Resources

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