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Skills

  • Benefits and compensation
  • Credentialing application process management
  • Effective provider-to-regulatory communication
  • Healthcare regulation documentation
  • Project organization
  • Relationship development
  • Recruitment
  • Budgets
  • Conflict resolution
  • Digital credentialing system implementation

Work Experiences

  • Planned and executed large-scale events that resulted in a 4% increase in employee participation.
  • Conducted credentialing audits.
  • Was in charge of administering benefit programs, analyzing compensation and other competitive data, and creating budgets.
  • Consistently updated management on credentialing statuses.
  • Achieved the fastest provider clearance in Phoenix.
  • Achieved excellent outcomes in 17 of external audit reviews.
  • Collaboratively worked with the insurance department to ensure all credentialing submissions were completed within 16 days of hire.
  • Achieved a 98% approval rate.
  • Collaboratively updated credentialing policies.
  • Achieved 85% reduction in incomplete submissions.

Summaries

  • Collaborated with healthcare providers.
  • Collaborated with senior leadership to refine credentialing operations, delivering impactful data-driven reports that influenced key decisions in policy management.
  • Assisted in building credentialing process workflows.
  • Capable of supporting interdepartmental initiatives by coordinating medical staff’s credentialing requirements, boosting overall compliance and readiness for regulatory audits.
  • 15 years of experience managing healthcare credentialing applications.
  • Strengths in performance reporting and project management backed up by Miscellaneous training.
  • Achieved 63% reduction in backlogs.
  • Assisted large-scale credentialing initiatives.
  • Boosted overall staff certifications by 83%.
  • Assisted in building credentialing process workflows, contributing to a 77% increase in administrative efficiency and team performance.

Accomplishments

  • Collaborated with IT to streamline and optimize the credentialing database system, reducing data retrieval time by 77%.
  • Ensured the timely credentialing of providers for payor enrollment, directly contributing to 84% increase in operational effectiveness for billing.
  • Managed verification processes for 16 providers' highest-priority credentials, ensuring we met critical healthcare accreditation deadlines.
  • Created custom, data-driven reports for senior management on credential verification statuses to support strategic decision-making.
  • Recommended process improvements to ensure credentialing met updated category requirements, resulting in full compliance audit pass.
  • Coordinated with state and federal agencies to keep up-to-date with evolving credentialing requirements, ensuring timely provider compliance.
  • Actively supported the credentialing process for 4 healthcare providers, meeting all compliance deadlines with 51% accuracy.
  • Assisted in the implementation of a cloud-based credentialing solution that minimized manual data entry, improving processing speed by 74%.
  • Developed an automated alerts system for credentialing renewal deadlines, reducing missed deadlines by 82%.
  • Collaborated with team of 15 in the development of system.

Affiliations

  • Society for Human Resource Management (SHRM)
  • Coalition of Health Professionals in Training (CHPT)
  • American Society of Administrative Professionals (ASAP)
  • American Medical Billing Association (AMBA)
  • American Medical Informatics Association
  • Association of Information Technology Professionals
  • Organization for Healthcare Administrative Management (OHAM)
  • Toastmasters
  • Society of Human Resource Management
  • Association of Healthcare Credentialing Officers (AHCO)

Certifications

  • Electronic Health Records (EHR) Management Certification - ServiceNow
  • Certified Medical Staff Services Manager (CMSSM) - 2023
  • Managed Care Credentialing Systems Certification - 2016, Power BI
  • Certified Public Accountant
  • Certified Public Accountant (CPA)
  • Project Management Professional (PMP)
  • Healthcare Compliance Program Development Certification - Vantage, Salesforce
  • Certified Provider Credentialing Specialist (CPCS) - 2024
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Accredited Credentialing Specialist (ACS) - Meridian

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