Experienced administrative professional with 3+ years in provider credentialing services. Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans.
Overview
6
6
years of professional experience
Work History
Credentialing Specialist
Vertava Health
01.2021 - 01.2023
Conducted primary source verifications such as background checks and board certifications.
Prepared records for site visits and file audits.
Obtained NPI numbers for providers and facilities and updated existing profiles.
Received and evaluated applications to look for missing and inaccurate information.
Enrolled providers and Medicaid and private insurance plans.
Developed and implemented onboarding and orientation programs for new employees.
Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency.
People Operations Coordinator
Vertava Health
01.2020 - 01.2021
Maintained company compliance with local, state, and federal laws, in addition to established organizational standards.
Maintained human resources regulatory compliance with local, state and federal laws.
Motivated employees through special events, incentive programs, and constructive feedback.
Coordinated employee grievances and disputes in timely and professional manner by finding constructive solutions.
Facilitated onboarding sessions and on-the-job training for new hires, bolstering employee job position knowledge and skillset.
Facilitated onboarding sessions and on-the-job training for new hires bolstering position knowledge and skillset.
Pre-screened resumes prior to sending to corporate hiring managers for consideration.
Developed and implemented onboarding and orientation programs for new employees.
Partnered with departmental managers to ascertain hiring needs and subsequently provide candidate recommendations.
Business Administrator
Vertava Health
01.2019 - 01.2020
Managed day-to-day development issues.
Fostered strong rapport with clients, vendors and stakeholders through consistent follow-up and communication.
Developed monthly reports.
Reduced office expenses by finding smarter solutions for vendors, suppliers and services.
Maintained electronic and paper filing systems for easy retrieval of information.
Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
Coordinated communications, financial processing, registration, recordkeeping, and other administrative functions.
Admissions Coordinator
LIFECORE Addiction Services
01.2017 - 01.2019
Confirmed all insurance benefits met standards of admissions as dictated by policy.
Managed admissions processes for incoming patients, promptly collecting and processing necessary documents.
Completed preliminary paperwork for incoming and outgoing patients.
Compiled and analyzed data to track admissions trends and make recommendations for improvements.
Contacted prospective patients via email and phone calls.
Collaborated with admissions team to develop and implement strategies to improve admissions process.
Assisted in patient admission process based on federal and state laws.
Education
High School Diploma -
New Site High School
01.2003
Skills
Regulatory Compliance
Provider Relations
Application Coordination
Accreditation Information Management
Facility Support
Management Collaboration
Report Generation
Employee Onboarding
CAQH Expertise
Provider Enrollment
Application Management
Record Keeping
Software Proficiency
References
Roxanne Crawford, 662.882.0098
Scott Salter, 615-509-2842
Leigh Ann Thompsom, 615-948-6597
Kristi Rifkin, 615-525-8179
Training
I have completed over 80 hours of various trainings within Relias training modules. I also have working knowledge of several Electronic Medical Records systems. I have countless hours of on-the-job training with various payor portals, including Medicaid.
Timeline
Credentialing Specialist
Vertava Health
01.2021 - 01.2023
People Operations Coordinator
Vertava Health
01.2020 - 01.2021
Business Administrator
Vertava Health
01.2019 - 01.2020
Admissions Coordinator
LIFECORE Addiction Services
01.2017 - 01.2019
High School Diploma -
New Site High School
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