Strong Customer Service Professional with a goal to exceed client's customer satisfaction.
Overview
18
18
years of professional experience
Work History
Network Operations Coordinator
Lancesoft Contract Assignment- Molina Healthcare
New York
12.2022 - 02.2024
Submit individual providers for credentialing upon review of state requirements
Manage and Maintain request for individual/group network/contract request/submit terms request/add provider to group/add sl to group (demographic updates/network status changes)
Excel review of credentialed approved providers, submit for par load upon completion of credentialing
Knowledge/experience with CAQH, State sites for licensing requirements, NPPES, TJC, OIG, AANP, SAM, CMS, PCM, IServe, excel and more.
Operations Analyst
Nomad Health
10.2021 - 11.2022
Conducting Background checks, ordering Drug Screens
Collecting medical documents and HR documents for HP
Uploading documents to 3rd party vendor
Communication with HP and client for timely transition from credentialing to hospital
Complete online database knowledge, working through Google Workspace
Playing starting role in crafting and implementing strategies and workflows to better serve nurses
Working with clinicians and tirelessly solving issues
Ensuring clinicians have the necessary qualifications and information needed while providing a best in class experience
Identifying ways to improve our processes and workflow
Being the eyes and ears of Nomad and always finding opportunities to improve the customer experience
Create a seamless experience for clinicians during extended hours
Embracing an "all hands on deck" culture
Help refine a successful operations and customer success workflow that delights our customers in a timely fashion and improves Nomad's Placement rate
The product and company needs always changing and being able to evolve with the time
Interact frequently with member of the operations, AM and product teams.
Credentialing Coordinator
Saber Healthcare Group
09.2017 - 09.2021
Responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages
Tracking yearly credentialing and oncoming facility network status
Word, Excel, Databases, and Power Point skills needed
Ability to manage a number of demanding projects simultaneously
Ability to be extremely well organized, with careful attention to detail and follow up
Overseeing delegated credentialing functions to subcontracted providers
Problem solves issues with obtaining required documents
Meets credentialing/re-credentialing deadlines
Maintains and tracks professional license renewals
Coordinates and processes all application for reappointment on a timely manner as required
Develops and maintains effective lines of communication necessary for CCF's day to day credentialing operations
Adheres to credentialing timeframes and deadlines dictated by regulatory bodies so that provider files stay in compliance at all times
Assists Manager in file review for annual audits by Manage Care Plans
Tracks and maintains all License, DEA, Malpractice Insurance, and Board Certification expiration dates
Strong ability to multitask and work independently
Coordinate work/test with other teams upon managers request
Projects outside work qualifications upon managers request.
Service Call Center-Customer Service Support level 3(project coordinator
Bass Security
08.2015 - 09.2017
Manage phone calls
Communication between vendors and clients
Provide/obtains updates on the status of a work order via phone/email
Provide accurate completion information to the client for invoicing.
Hazard Claims Coordinator
Safeguard Properties, LLC
01.2014 - 01.2015
Manage claims on a timely basis
Submit dispute when needed
Verify corrective information on claim conclusion
Verify funds
Communication between Clients, Vendors, and Insurance carriers for accurate information
Confirm all correct information on opening, and closing claims.
Customer Service Representative/Assistant Manager
Rac Acceptance
San Antonio, TX
01.2012 - 01.2014
Collections-phone calls
Customer service
Closing contract deals
Clerical work, etc.
Cashier (box office)
Regal Entertainment
San Antonio, TX
01.2011 - 01.2012
Cashier
Home Depot
San Antonio, TX
01.2008 - 01.2009
Lifeguard, Swim Instructor
Mandel JCC
Beachwood, Ohio
01.2006 - 01.2008
Office Administration
College Planning Network
Beachwood, Oh
Financial Aid Assistant team connecting taxes to FAFSA
Working with and making sure accurate numbers are added for future aid for individual families
Reviewing tax information before submitting
Data entry of information into system
Reviewing information in files.
Education
Skills
Exceptional ability to communicate & motivate others as well as being efficient
Resolve problems and bring the project to a completion on time
Excellent Clerical skills with knowledge of office equipment
Proficient data entry
Strong organizational skills
Hard worker who can be relied on to complete tasks accurately and independently
Typing( WPM:63)
Quick learner, especially with hands-on job abilities
Skilled in Microsoft Office (Word, Outlook, Excel, PowerPoint) Google workspace
Adaptable to change in work flow/systems
Application Configuration
Multitasking
Analytical Thinking
Time management abilities
Diagnosing issues
Self Motivation
Reliability
Effective Communication
Problem-Solving
Project Management
Continuous Improvement
Organizational Skills
Goal Setting
Professionalism
Attention to Detail
Graduation Date
06/01/08
Personal Information
Title: Diploma
References
References available upon request
Timeline
Network Operations Coordinator
Lancesoft Contract Assignment- Molina Healthcare
12.2022 - 02.2024
Operations Analyst
Nomad Health
10.2021 - 11.2022
Credentialing Coordinator
Saber Healthcare Group
09.2017 - 09.2021
Service Call Center-Customer Service Support level 3(project coordinator
Customer Support Agent at Lancesoft (Contract Term with Manulife Group Benefits)Customer Support Agent at Lancesoft (Contract Term with Manulife Group Benefits)
Customer Service Specialist/Receptionist/Document Specialist at Robert Half Contract AssignmentCustomer Service Specialist/Receptionist/Document Specialist at Robert Half Contract Assignment