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Skills

  • Team management
  • Regulatory compliance
  • Data accuracy and validation
  • Electronic records management systems
  • Operational improvement
  • Multilingual proficiency (Japanese)
  • Project organization
  • Continuous process improvement
  • Error rate reduction
  • Problem resolution

Work Experiences

  • Created detailed tracking reports for internal quality audits, achieving an accuracy rate exceeding 35%.
  • Achieved a 60% drop in late document submissions.
  • Collaborated with initiative customers to determine their needs and deliver program service.
  • Collaborated with program board.
  • Addressed credential discrepancies involving metric cases.
  • Achieved successful resolution in 45% of cases.
  • Looked for industry trends on social media and through online sources.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Collaborated with recruitment teams.
  • Collaborated with external insurance agencies.

Summaries

  • Aligned operations with state and federal regulations.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Collaborative professional with mastery in coordinating licensing processes, negotiating complex certification discrepancies, and minimizing compliance risks across Austin.
  • Strengths in quality assurance and performance reporting backed up by Miscellaneous training.
  • Achieved 17% data accuracy improvement.
  • Championed a quality control initiative that reduced credentialing errors by 42% while enhancing compliance for over 7 healthcare providers.
  • Contributed to a 23% improvement in auditing processes.
  • Detail-oriented professional experienced in regulatory compliance.
  • Credentials Coordinator is a multi-talented Credentials Coordinator who is consistently rewarded for planning and operational improvements.
  • Driver of credential risk management strategies.

Accomplishments

  • Strengthened relationships with external partners, resulting in a 51% improvement in credential verification response times from third-party agencies.
  • Trained a team of 6 staff members on updated regulatory requirements, improving overall dept. Accuracy by 39%.
  • Facilitated the swift onboarding of 12+ providers through consistent communication with state medical boards and licensing entities.
  • Collaborated with team of 7 in the development of process.
  • Worked closely with the legal department and ensured stringent compliance with standard regulations for licensure verification.
  • Authored a credentialing procedure that was adopted across 12 regional offices, resulting in 43% increased standardization and compliance.
  • Collaborated with cross-functional teams to perform audit and correction of credential files before annual federal/state licensing inspections.
  • Achieved 69% improvement in reviewer turnaround by revamping the peer review process and adopting a more structured credentialing timeline.
  • Improved credentialing processing time by 84% through automation of manual tasks, drastically reducing submission errors.
  • Reduced delays in credentialing by 30% through the streamlining of internal workflows and establishment of SLAs with key departments.

Affiliations

  • National Healthcare Coder Association (NHCA)
  • Medical Auditing Professionals Association (MAPA)
  • Federation of Regulatory Counselor (FRC) for Healthcare Professionals
  • American Academy of Professional Coders (AAPC)
  • Accreditation Association for Ambulatory Health Care (AAAHC)
  • American College of Healthcare Executives (ACHE)
  • Freemason
  • Commission on Accreditation of Healthcare Management Education (CAHME)
  • Project Management Institute
  • American Medical Group Association (AMGA)

Certifications

  • Microsoft Certified Systems Engineer (MCSE)
  • Certified in Healthcare Credentialing and Provider Enrollment (CHCPE)
  • Advanced Professional Communication in Healthcare Credentialing Certificate
  • Credentialing Tracking Software Proficiency Certification
  • Certified Compliance Specialist (CCS)
  • CompTIA Network+
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Leadership in Credentialing and Provider Enrollment (LCPE)
  • Managed Care Credentialing Specialist (MCCS)
  • AHIP Credentialing Professional from Vantage

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