ABIGAIL VALDEZ
San Diego,CA
Summary
Dependable employee with a keen interest in Human Resources, seeking opportunity to expand skills and contribute to company success. Considered hardworking, ethical and detail-oriented.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Team Lead Credentialing Specialist
Host Healthcare
San Diego, CA
05.2023 - Current
- Collaborated with medical staff leadership in the review and approval process for privileges requests
- Facilitated communication among practitioners, practice administrators, medical staff leaderships on matters pertaining to compliance policies or procedures
- Assisted with ongoing compliance initiatives by conducting periodic audits of practitioner files or processes related to credentialing activities
- Maintained a 98% score on audits
- Implemented improvements in compliance processing workflows based on QA performance metrics analysis
- Reached 98.6% on time starts
- Prepared and provided information for internal and external customers as appropriate
- Improved employee retention by increasing job satisfaction and enhancing communication
- Reviewed provider documents to promote compliance with quality and regulatory standards
- Lead team meetings and train new team members
- Served as liaison between healthcare providers and payer organizations during enrollment or contracting negotiations.
Credentialing Specialist III
Host Healthcare
San Diego, CA
08.2022 - 05.2023
- Filled individual provider files and applications with up-to-date information
- Ensured adherence to HIPAA privacy regulations while handling sensitive personal information about practitioners
- Reviewed and evaluated practitioner applications for completeness and accuracy
- Participated in continuing education opportunities related to quality assurance standards, regulations, or accreditation requirements
- Cross Trained colleagues on various aspects of compliance process to ensure continuity of services during absences
- Reviewed provider documents to promote compliance with quality and regulatory standards
- Maintained a 97% on audits and on time starts
- Assisted with ongoing compliance initiatives by conducting periodic audits of practitioner files or processes related to credentialing activities.
Credentialing Specialist I
Host Healthcare
San Diego, CA
02.2022 - 08.2022
- Developed and implemented credentialing process improvements and prepared reports
- Prepared and submitted provider enrollment applications to insurance carriers
- Maintained accurate electronic credentialing files for each practitioner
- Updated provider database documents and profiles according to preset schedules.
Education
Bachelor of Science (B.S.) - Kinesiology -
University of California, Sacramento
Sacramento, CA03.2020
Skills
- Onboarding
- Team Collaboration
- Customer Success
- Strong Attention to Detail
- Regulatory Compliance
- Analytical Skills
- Process Improvement
- Problem-Solving
- Project Coordination
- Time management
Middleinitial
A V
Certification
HRCI Human Resource Associate Professional Certificate
Timeline
Team Lead Credentialing Specialist
Host Healthcare
05.2023 - Current
Credentialing Specialist III
Host Healthcare
08.2022 - 05.2023
Credentialing Specialist I
Host Healthcare
02.2022 - 08.2022
Bachelor of Science (B.S.) - Kinesiology -
University of California, Sacramento