Summary
Overview
Work History
Education
Skills
References
Certification
Additional Information
Timeline
Generic

Crystal Tucker, MNM, CPCS

Jacksonville,FL

Summary

Administrative leader offering experience prioritizing and delegating administrative tasks to drive goal achievement. Proficient in management, medical records and credentialing, resource allocation and office supply inventory management. Dedicated to training and mentoring top talent while cultivating a productive work culture.To obtain a position which will afford me long term stability and provide the opportunity to advance into a leadership role.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Board of Directors Member

Seeds Of Love Ministries
09.2023 - Current
  • Collaborated with 4 other members to seek involvement in policy decisions, fundraising and visibility of organization.
  • We very strategically stretch donated funds we receive to serve about 200 homeless and low-income individuals a month in Northeast Florida through our weekly assistance program and monthly community outreach initiatives.
  • We also partner with aligned nonprofits and organizations through community events to increase the value of our combined impact. One of our major events is a yearly Back-to-School outreach that provides children with backpacks, school supplies, shoes, and clothing to empower them for a strong, successful start to the school year!

Medical Staff Office- Manager

Baptist Medical Center Jacksonville
12.2017 - Current
  • Ensures that the credentialing, re-credentialing, and other activities of the Medical Staff are maintained in accordance with the Baptist Health Hospital Bylaws, Rules & Regulations, Policies/Procedures and regulatory standards
  • Manages Medical Staff Administration activities and provides support to ensure the efficient operations of the Medical Staff Services
  • Evaluates employee performance and provides counseling as appropriate
  • Serves on hospital committees and attends meetings in place of director when requested
  • Monitors departmental policies and procedures to ensure timeliness and concurrency with actual practices
  • Provides guidance and expertise to the satellite hospitals to ensure that policies, Bylaws/R&R’s are adhered to
  • Regularly provides reports and education to staff at monthly staff meetings
  • Responds to all concerns escalated by physicians and external customers as they relate to the credentialing and re-credentialing processes
  • Creates credentialing criteria as needed in conjunction with the Director and medical staff leadership
  • Responsible for the coordination of Medical Staff Elections and Appointments annually
  • Attend local FAMSS Chapter meetings
  • Communicated effectively with staff members, physicians, and patients, employing active listening and interpersonal skills.
  • Addressed and remedied all patient or team member issues.
  • Developed policies and procedures for effective practice management.
  • Consulted with healthcare professionals on business decisions.
  • Created and implemented organizational policies and procedures.
  • Oversaw accounting, budgeting, and financial reporting.
  • Assisted with regulatory issues such as compliance.
  • Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties.
  • Managed 12 employees with various personalities and from different cultures for large 6 Hospital health care system, comprising of 2,600- Physicians & Allied Health Professionals.
  • Organized and updated databases, records and other information resources.
  • Cultivated strong relationships with vendors and partners supporting administrative operations.
  • Identified opportunities to streamline processes and improve office operations and efficiency.
  • Coordinated office events, seminars and meetings for staff and clients.
  • Created organized filing system to manage department documents.
  • Created reports, presentations and other materials for executive staff.
  • Maintained primary relationship accountability for clients, overall servicing responsibility and client satisfaction to maximize profitability of client relationships.
  • Built and managed processes for tracking and monitoring department performance.
  • Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
  • Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
  • Implemented project management techniques to overcome obstacles and increase team productivity.
  • Built highly-efficient administrative team through ongoing coaching and professional development opportunities.
  • Improved office operations by automating client correspondence, record tracking and data communications.
  • Completed bi-weekly payroll for 12 employees.

Medical Staff Office- Sr. Credentialing Specialist

Baptist Medical Center Jacksonville
05.2016 - Current
  • Acts as lead Credentialing Specialist and assists in the development, implementation and monitoring of the credentialing process required by State and Federal laws, hospital accreditation and Joint Commission standards
  • Acting on behalf of the Manager/Director in his/her absence, managing the work flow of other Credentials Specialists, preparing for and follow up on outstanding issues of the Credentialing Committee
  • Serves as team lead for Joint Commissions at Wolfson Children’s Hospital
  • Provides training to Credentialing Specialists, as needed
  • Attends local association and cooperative credentialing meetings to stay current with trends and best practices
  • Appropriately processes requests and accurately maintains records of applications for physicians
  • Reviews applications for completeness and conducts primary source verifications in a timely manor
  • Coordinates interviews for new physicians
  • Processes requests for temporary privileges as appropriate
  • Practitioner data is accurately entered into the database and SMS/WILMA when a new practitioner has been approved by appropriate committees
  • Prepares agenda and other meeting materials for the Credentials Committee Meetings
  • Prepares for Physician Orientation Meetings
  • Provides guidance and expertise to staff and practitioners in regards to policies, Bylaws/R&R’s and other regulatory requirements
  • Responds to requests for labels and rosters
  • Identifies and participates in ongoing Performance Improvement needs
  • Assists Manager and/or Director with special projects as assigned.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.

Medical Staff Office- Credentialing Specialist

Baptist Medical Center Jacksonville
11.2013 - 05.2016
  • Appropriately processes requests and accurately maintains records of applications for physicians
  • Reviews applications for completeness and conducts primary source verifications in a timely manor
  • Coordinates interviews for new physicians
  • Processes requests for temporary privileges as appropriate
  • Practitioner data is accurately entered into the database and SMS/WILMA when a new practitioner has been approved by appropriate committees
  • Prepares agenda and other meeting materials for the Credentials Committee Meetings
  • Prepares for Physician Orientation Meetings
  • Provides guidance and expertise to staff and practitioners in regards to policies, Bylaws/R&R’s and other regulatory requirements
  • Responds to requests for labels and rosters
  • Identifies and participates in ongoing Performance Improvement needs
  • Assists Manager and/or Director with special projects as assigned.

Credentialing Department

Borland Groover Clinic
02.2013 - 11.2013
  • Answer Provider Service phone calls and emails from enrollment for all provider types
  • Identify and resolve all issues that arise during enrollment for all provider types
  • Prepare applications for initial enrollment in managed care plans, hospitals and professional organizations
  • Responsible for upkeep of the provider profiles on the Department of Health
  • Process requests for re-credentialing from the managed care plans, hospitals and professional organizations for all provider types, as requested
  • Track all CME for providers and prepare quarterly reports for the providers to be updated on how many hours they have accumulated during the current renewal period
  • Work closely with the Administrative team, to receive updates on new providers joining the organization, group acquisitions, new or terminated managed care contracts, new service locations, physicians requiring enrollment at a new facility (i.e
  • Surgery centers or hospitals) and notice of intent for any medical malpractice claims
  • Required to keep documentation of all enrollments, reenrollments for three years
  • Generally, support the managed care company’s provider representatives with necessary information for initial credentialing purposes
  • Responsible for all Physician License and DEA renewals
  • Attend meetings, as necessary, to discuss status of enrollment, mergers and updates with the administrative team
  • Credentialing for an Ambulatory Surgery Center (Southpoint Surgery Center)
  • This involves renewing and insuring that all applications received are accurate
  • Collecting and verifying DEA’s, Licenses and Board Certifications
  • Retrieving NPDB to insure that physicians accurately disclosed any Malpractice cases that may have been reported
  • Performing all Primary Source verifications and ensuring that the providers are appropriately credentialed to perform the privileges that they are requesting.

Education

Master’s Degree, Nonprofit Management -

University of Central Florida
05.2020

Bachelor’s Degree, Supervision and Management -

Florida State College at Jacksonville
06.2011

Associates Degree, General Education -

Florida State College at Jacksonville
06.2008

High school Diploma -

First Coast Christian School
Jacksonville, FL
05.2005

Skills

  • Self-Motivated
  • Even-tempered
  • Dependable
  • Creative
  • Task- Oriented
  • Operational Efficiency
  • Continuous Improvement Process
  • Critical Thinking
  • Physician Coordination
  • Office Management Software
  • Operational Improvements
  • Microsoft Office
  • Effective Multitasking
  • Best Practices and Standards
  • Training and Development
  • Department Leadership
  • Update Policies
  • Control of Expenses
  • Records and Database Management
  • Office Supplies and Inventory

References

Personal References available upon request

Certification

  • Certified CPCS, NAMSS- National Association Medical Staff Services - 10/2019

Additional Information

Volunteer Experience:

Volunteer with Seeds of Love Ministries, Mercy Support Services in Clay County.

The Players Center, On Our Sleeve Events.



Presentations:

Invited:

The Criticality of Provider Credentialing: What the experts need the C-Suite to know. September 28, 2023 Live Webinar. Sponsored by Beckers Healthcare review and Symplr.


Timeline

Board of Directors Member

Seeds Of Love Ministries
09.2023 - Current

Medical Staff Office- Manager

Baptist Medical Center Jacksonville
12.2017 - Current

Medical Staff Office- Sr. Credentialing Specialist

Baptist Medical Center Jacksonville
05.2016 - Current

Medical Staff Office- Credentialing Specialist

Baptist Medical Center Jacksonville
11.2013 - 05.2016

Credentialing Department

Borland Groover Clinic
02.2013 - 11.2013

Master’s Degree, Nonprofit Management -

University of Central Florida

Bachelor’s Degree, Supervision and Management -

Florida State College at Jacksonville

Associates Degree, General Education -

Florida State College at Jacksonville

High school Diploma -

First Coast Christian School

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Crystal Tucker, MNM, CPCS