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Skills

  • TCP/IP
  • Data entry
  • Project organization
  • First Aid/CPR
  • Team management
  • Time management
  • Process improvement
  • Risk mitigation
  • Cross-functional collaboration
  • Category equipment

Work Experiences

  • Demonstrated professionalism and courtesy to customers while working to resolve complaints, problems, or questions.
  • Avoided penalties of up to $6.
  • Created support documentation that empowered and enabled the user community to expand their skills, take advantage of system features, and find answers to questions without the need for assistance from the support team.
  • Achieved results within the first 6 months.
  • Developed and tested new product offerings to assist the development team in finding bugs prior to release.
  • Collaborated with IT to implement a data validation tool.
  • Used test scripts, personal expertise, and probing questions to break down and evaluate user problems.
  • Achieved President's Club for consistently maintaining a 54% or higher real-time data accuracy rate.
  • Automated data validation checks for provider entries, reducing manual oversight by 45% and improving accuracy.
  • Used process improvement and cross-functional collaboration to maintain servers and systems, ensuring that networks remained fully operational during peak periods.

Summaries

  • Specializes in category and method product troubleshooting.
  • Achieves compliance excellence by ensuring 100% adherence to federal and state regulations in provider contracting, avoiding penalties and maintaining smooth operations.
  • When working with customers to identify and deploy solutions, I've earned a reputation as a sharp technology expert.
  • Provider Maintenance Specialist with 8 years of successful process improvement and project management experience.
  • Effectively troubleshoots and resolves issues on its own.
  • Achieved Outstanding Service Award for excellence in management.
  • Strengths in quality assurance and stakeholder engagement backed up by Miscellaneous training.
  • Promotes client relations and strategic planning skills that are dynamic.
  • 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 standard business.

Accomplishments

  • Developed a comprehensive provider feedback system, which reduced the gap between issue identification and resolution to an average of 18 days.
  • Collaborated with the IT team to automate certain aspects of provider credentialing, reducing manual inputs and cutting errors by 20%.
  • Spearheaded a data auditing initiative that identified and resolved 7 discrepancies across provider files, securing compliance within 6 months.
  • Executed a gap analysis in the provider onboarding process, reducing average onboarding time from 15 days to 3 days.
  • Rebuilt and standardized a manual process by developing a scalable solution that improved provider relations and reduced inquiries by 64%.
  • Analyzed trends in provider complaints and implemented proactive measures, reducing overall complaints by 65% in 2024.
  • Collaborated across departments to enhance the provider self-service portal, improving user satisfaction scores by 57% over 11 months.
  • Designed a comprehensive audit system for provider records to ensure continued adherence to CPA standards, achieving a 73% compliance rate.
  • Created and delivered compliance training sessions to staff on provider maintenance systems, leading to a 27% increase in data entry accuracy.
  • Created a protocol for bi-annual audits of provider information that ensured process compliance and reduced compliance gaps by 50%.

Affiliations

  • URAC Accreditation Evaluator
  • American Association for Physician Leadership (AAPL)
  • National Association for Healthcare Quality (NAHQ)
  • Provider Data Management Quality Assurance Team Member
  • Toastmasters
  • California Association of Credentialing Specialists
  • Project Management Institute
  • Jaycees
  • State/Federal Healthcare Compliance Forums
  • Professional Association for Healthcare Office Management (PAHCOM)

Certifications

  • Electronic Health Records Specialist Certification (CEHRS)
  • Certified in Healthcare Compliance (CHC)
  • ServSafe
  • Accredited Healthcare Fraud Investigator (AHFI)
  • Cisco Certified Network Associate (CCNA)
  • Certified Medical Credentialing Specialist (CMCS)
  • Lean Six Sigma Green Belt
  • SHRM Senior Certified Professional (SHRM-SCP)
  • CompTIA Security+
  • Health Information Management Professional (RHIA)

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