Alma B. Dominguez

• Supervising quality of incoming and outgoing phone calls
• Monitoring accurate insurance data entry
• Overseeing check-in and check-out process
• Auditing daily metrics of each patient seen or appointments cancelled
• Verification of insurance for each patient
• Medical Records processing
• End of day closing
• Completed bi-weekly payroll for 12 employees.

In and out bound phone calls to members

• Resolving incoming call with member concerns
• Process flex card reimbursement request from members
• Reviewed and analyzed claim submissions for accuracy, identifying discrepancies and facilitating timely resolutions.
• Implemented process enhancements that reduced claim processing times and improved customer satisfaction ratings.
• Conducted quality audits on processed claims, leading to increased accuracy and compliance with industry standards.

• Oversee credentialing team and ensure accurate and timely submission of documents, credentials, applications, and integrity guidelines.
• Plan and schedule the work of assigned staff to make maximum effective utilization of employees, equipment, and material within budgetary required.
• Monitor the initial appointment, re-appointment, ongoing monitoring, and expiration process for all providers ensuring compliance with regulatory bodies (including but not limited to URAC, NCQA, HHSC, Federal and State) as well as DHP Credentialing policies and procedures, and delegated contracts.
• Perform all credential file secondary verification activities at a supervisory level to ensure meeting quality and productivity standards and timelines.
• Maintain monthly progress meetings with new employees of their training
• Attend monthly board committee meetings
• Maintain weekly huddles with credentialing department for updates
• Validate and audit monthly completed credentialing work after committee approval
• Perform other duties as assigned to facilitate the organizational goals
• Led team in evaluating provider applications, improving review efficiency and accuracy.

• Payroll for 10 physicians and 32 employees
• Responsible for submitting 401K participation for all company staff on every payroll
• Responsible for maintaining credentialing documents for 10 physicians to include to hospitals and health plans
• HR duties for 42 employees
• Keeper of timecards to include
• Quick Books data entry of all incoming health plan money
• All my monthly quick books entries were submitted for checks and balances
• Overseeing 2 office locations
• Medical records
• Developed office policies that improved productivity and employee satisfaction across teams.
• Managed vendor relationships, negotiating contracts for cost savings while maintaining high-quality services.
• Developed comprehensive policy manuals outlining procedures and guidelines, contributing to a well-organized workplace culture.
• Improved team morale and cohesion with regular team-building activities and open communication channels.