Debbie Fuller
Silsbee,TX
Overview
21
21
years of professional experience
Work History
Delegated Provider Enrollment Credentialing Specialist
Rural Health Enterprise
Remote, WA
11.2024 - Current
- Delegated provider credentialing, roster updates and management, monthly and quarterly reporting, proficient in MD Staff, running primary source verifications, sanctions checks and research, compiling provider files for presentation at monthly credentialing committee and clean files review by medical director, other duties as assigned.
Provider Credentialing Specialist
Wonderland Child & Family Services
11.2023 - 06.2024
- Primary source verifications
- Licensing and certifications updates
- Provider sanctions reviews and follow-up as needed
- Confirming quarterly provider attestations (CAQH and OneHealthPort)
- Quarterly insurance company roster verifications for agency
- Initial and recredentialing providers
- Maintaining and updating provider credentialing records
- Job aids creation and updates
- Performing file audits to verify compliance with CMS policies
Provider Credentialing Specialist
Kaiser Foundation Health Plan of Washington
01.2022 - 01.2023
- Data Analysis
- Licensing, certifications and education verification
- Sanctions review and follow-up
- Practitioner and facility complaints review and follow-up
- Departmental reporting
- User testing assistance collaborating with IT and senior Analyst as needed
- Maintaining and updating Credentialing database
- Credentialing committee assistance and Credentialing SharePoint site administrator
- Process creation and updates
Provider Credentialing Analyst
Kaiser Foundation Health Plan of Washington
01.2015 - 10.2021
- Data Analysis
- Licensing, certifications and education verification
- Sanctions review and follow-up
- Practitioner and facility complaints review and follow-up
- Departmental reporting
- User testing assistance collaborating with IT and senior Analyst as needed
- Maintaining and updating Credentialing database
- Credentialing committee assistance and Credentialing SharePoint site administrator
- Process creation and updates
Senior Administrative Specialist
Group Health Cooperative
03.2012 - 01.2015
- Scheduling and coordinating quarterly performance and development reviews for 40+ in- office and remote nurses
- Providing high-level administrative support for MDs and two nurse managers
- Monthly and quarterly reporting for department
- Scheduling and preparing staff meetings
- Acting as liaison between Consulting Nurse Service and IT
- Office supply ordering and distribution
- Scheduling interviews
- Assisting with on-boarding new hires
Sales Operations Analyst
Group Health Cooperative
Seattle, WA
02.2010 - 03.2012
- Broker commission statements
- Broker portal support
- Monthly and quarterly reporting
Sales Account Manager
Group Health Cooperative
Seattle, WA
04.2005 - 02.2010
- Sales account management
- Broker portal and phone line support
- Broker symposium and other broker events coordination
- Monthly and quarterly reporting
Timeline
Delegated Provider Enrollment Credentialing Specialist
Rural Health Enterprise
11.2024 - Current
Provider Credentialing Specialist
Wonderland Child & Family Services
11.2023 - 06.2024
Provider Credentialing Specialist
Kaiser Foundation Health Plan of Washington
01.2022 - 01.2023
Provider Credentialing Analyst
Kaiser Foundation Health Plan of Washington
01.2015 - 10.2021
Senior Administrative Specialist
Group Health Cooperative
03.2012 - 01.2015
Sales Operations Analyst
Group Health Cooperative
02.2010 - 03.2012
Sales Account Manager
Group Health Cooperative
04.2005 - 02.2010