Knowledgeable healthcare professional skilled in credentialing, compliance, and medical chart auditing. I excel in resolving discrepancies, meeting deadlines, and delivering quality results in fast-paced environments.
Overview
8
8
years of professional experience
Work History
Credentialing Specialist
Blue Cross Blue Shield
Dallas, TX
05.2022 - 03.2026
Coordinated with medical staff to obtain necessary credentialing documents.
Prepared and submitted provider enrollment applications to insurance carriers.
Conducted primary source verifications of education, training, licensure, and malpractice history.
Reviewed provider documents to promote compliance with quality and regulatory standards.
Responded to credentialing verification inquiries from medical staff.
Compliance Specialist
1-800 Contacts
Dallas, TX
01.2020 - 02.2022
Accurately entered prescription information from eye care providers and patients.
Maintained compliance with HIPPA patient confidentiality requirements.
Responded to emails, chats, and calls from eye care providers and patients.
Resolved prescription and data entry discrepancies.
Punctually processed orders for scheduled delivery dates.
Medical Chart Auditor
Ciox Health
Dallas, TX
08.2018 - 01.2020
Provided feedback to healthcare providers regarding medical chart discrepancies.
Performed administrative duties such as filing, scanning, copying and faxing.
Investigated complaints related to incorrect or incomplete patient records.
Transcribed medical records.
Ensured that all changes made during an audit were properly documented.