Deanna Hines
Houston,TX
Summary
Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving, communication skills. and multi-state credentialing.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Quality Assurance Reviewer- Credentialing
Astrana Health
03.2025 - 10.2025
- Managed and updated credentialing databases to reflect accurate provider information and documentation.
- Conducted thorough primary source verifications of licenses, certifications, and training for healthcare professionals.
- Maintained documentation for credentialing files in accordance with federal and state regulations.
- Streamlined the credentialing workflow by implementing standardized processes and checklists.
Credentialing Coordinator
Tango
07.2023 - 07.2024
- Managed and updated credentialing databases to reflect accurate provider information and documentation.
- Conducted thorough primary source verifications of licenses, certifications, and training for healthcare professionals.
- Facilitated communication between providers and insurance payers to expedite credentialing approvals.
- Monitored expiration dates of provider credentials and certifications, implementing reminders for timely renewals.
Sr. Credentialing Specialist
HonorHealth
02.2020 - 06.2023
- Conducted thorough primary source verifications, ensuring accuracy and validity of physician qualifications.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Conducted primary source verifications such as background checks and board certifications.
- Utilized data management systems to track credentialing progress and facilitate reporting.
- Conducted audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
Grievance and Appeals Representative
Centene
09.2018 - 10.2019
- Reviewed and processed grievance cases, ensuring compliance with regulatory standards and internal policies.
- Communicated effectively with clients regarding the status of their grievances and appeals.
- Obtained additional documentation required for case review.
- Managed sensitive client information with confidentiality and discretion, maintaining trust between customers and the company.
Transplant Scheduling Coordinator
Wake Forest Baptist
10.2017 - 09.2018
- Coordinated appointment schedules for multiple departments, ensuring efficient use of resources and timely patient care.
- Managed provider schedules to enhance patient access and minimize wait times, contributing to improved patient satisfaction.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
Eligibility Specialist
Meritain Health
11.2015 - 07.2017
- Reviewed and processed applications for eligibility, ensuring all required documents were submitted and accurate.
- Collaborated with external agencies to gather necessary information for eligibility assessments.
- Managed data entry and maintained accurate records of client eligibility status in the database.
- Communicated effectively with clients to explain eligibility requirements and assist with the application process.
Education
AAS - Liberal Arts & Sciences
Bachelor of Science - Healthcare Administration
02-2027
- Dean's List [Spring 2024]
- Honor Roll Fall 2025
- 3.7 GPA
Skills
- Background checks
- Provider enrollment
- Data management
- Credentialing oversight
- Application coordination
- Modio, CredentialStream, MD Staff expertise
- License verifications
- Facility credentialing
- Audit preparation
Certification
- Certified Professional Credentialing Specialist - April 2026
Timeline
Quality Assurance Reviewer- Credentialing - Astrana Health
03.2025 - 10.2025
Credentialing Coordinator - Tango
07.2023 - 07.2024
Sr. Credentialing Specialist - HonorHealth
02.2020 - 06.2023
Grievance and Appeals Representative - Centene
09.2018 - 10.2019
Transplant Scheduling Coordinator - Wake Forest Baptist
10.2017 - 09.2018
Eligibility Specialist - Meritain Health
11.2015 - 07.2017
Community College of Baltimore County - AAS, Liberal Arts & Sciences
Southern New Hampshire University - Bachelor of Science, Healthcare Administration