ANGELA CARON

Responsible for processing reappointment for providers already in network.

Verification of providers credentials according to plans and policy.

Maintain providers re credentialing files between cycles.

Intake requests for re credentialing and ensure that all applicable documents have been received. Reach out to the credentialing contact or providers if need be for any missing documentation.

Verify provider applications for re credentialing to meet all company requirements and standards.

Provide status updates to credentialing contact or provider on the progress of their re credentialing process.

Document effective and efficient data for re credentialing in sympler provider and ensure data entry accuracy.

Conducts self reviews of re credentialing applications prior to submitting to credentialing committee to ensure standards are applied.

Manages and prioritizes assigned tasks to ensure compliance with regulatory requirements while achieving department goals.

Other office duties as assigned by management.

• Interacted with customers by phone, email, or in-person to provide customer service.
• Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
• Maintained electronic and paper filing systems for easy retrieval of information.
• Coordinated communications, financial processing, registration, recordkeeping, and other administrative functions.
• Assisted in organizing and overseeing assignments to drive operational excellence.

• Handle credentialing for all newly hired Physical therapists.
• Work with many different systems, insurance websites and portals. Examples:

NPDB, CAQH, PECOS, Prompt, Clinicient, etc.

• Checks the Department of Health daily to keep track of PT licenses to ensure they are active and up to date.
• Worked in Excel to keep track of any daily changes.
• Answered all emails, phone call & faxes related to credentialing & medical records.
• Handled all the filing (electronic and paper) for credentialing & medical records.

• Receive and process medical records request and ensure that they were processed in a timely manor.
• Data entry into multiple systems examples: Clinicient, Promt etc.
• Communicate daily through multiple sources.
• Faxed, mailed & emailed patient records daily, ensuring compliance with HIPPA regulations to maintain patient confidentiality and data security.
• Train team members to ensure they are equipped with the necessary skills and knowledge to meet performance expectations and regulatory standards.

• Receive and process medical record requests.
• Review medical records for completeness and file records in alphabetic and numeric order o Input data into computer programs and filing systems.
• Sort materials and file according to guidelines.
• Review charts and flag incomplete or inaccurate information.
• Obtain patient release forms to authorize dissemination of medical information in compliance with privacy regulations.
• Prepare mailings of information and documentation.
• Evaluate department procedures and recommend improvements to maximize efficiency.
• Review documentation for compliance with requirements and accuracy of information.
• Set up new patient charts after admission to the hospital.
• Prepare and send out records for aftercare once patients were released from hospital.
• Maintain strict patient and physician confidentiality.
• Answered multiple phone calls per day
• Provided assistance to coworkers during high workload periods to ensure timely completion of tasks and maintain team productivity.

• Politely greet customers
• Manage bar inventory, restock supplies and place orders o Handle money, process credlt card payment batches and handle lottery
• Follow all safety requirements for alcohol service while keeping facility compliant with health codes, sanitation requirements and license regulations
• Maximize customer service by training staff and resolving issues in a timely manner
• Greet guests in a timely and professional manner o Notify a manager if a patron is intoxicated or rude to other patrons
• Notify management of ordering needs (liquor, beer, wine, paper goods, etc.) o Clean shelving, mixers, cups, blenders and soda guns
• Retrieve liquor, wine and beer from various storage facilities o Serve each guest courteously, quickly and efficiently.

• Earned management trust by serving as key holder, responsibly opening and closing store
• Greeted all customers providing them with great customer service in a timely manor.
• Took inventory of all products.
• Baked and made the pastries.
• Kept store very organized and clean to ensure the store would always pass inspection.
• Answered product questions with up-to-date knowledge of sales and store promotions.
• Bagged, boxed or gift-wrapped sold merchandise per customer's request.
• Helped drive sales goals and achieve monthly quotas.