Donna Salcido
Texas City,TX
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
2025
2025
years of professional experience
1
1
Certification
Work History
Managed Care Quality Coordinator
Coastal Health & Wellness
04.2024 - 01.2025
- Responsible for identifying patients overdue for certain CMS and HEDIS quality measures to close quality gaps
- Collaborate with staff and partners to report accurate value based performance
- Assisted in developing and maintaining quality management chart documentation, and assisted with quality assurance initiatives by conducting chart audits and inspections
- Collaborated with team members to identify areas for process improvement
- Analyzed data trends to identify opportunities for process improvements, leading to a more efficient workflow and higher quality output
- Coordinated quality assurance processes to enhance service delivery across healthcare teams.
Credentialing and Privileging Manager
Coastal Health & Wellness
08.2022 - 04.2024
- Managed the credentialing and re-privileging program processes of healthcare providers, and ensuring compliance with regulatory standards
- Conducted primary source verification
- Prepared and submitted enrollment applications, tracking application statuses, resolving any issues during the enrollment process
- Maintained confidential, accurate paper and electronic provider records, and ensured accuracy of provider data in internal databases through regular review and updates
- Coordinated closely with human resources to ensure seamless integration of hiring activities into the overall credentialing process
- Prepared and facilitated monthly meetings to discuss approval of initial credentialing and re-privileging of healthcare providers, progress toward goals, troubleshoot issues, and conducted audits of credentialing files to maintain accuracy and consistency in documentation
Executive Administrative Assistant
Galveston County Health Ditrict
01.2011 - 08.2022
- Responsible for providing Executive support for the Chief Nursing Officer (CNO), Director of community Health Services (CHS) and CHS office.
- Served as CHS Asset Custodian
- Enters all CHS departments orders into Accufund.
- Manages Class D pharmacy
- Responsible for providing administrative support for the DFEET/BCCS Breast and Cervical Cancer Programs.
- Responsible for invoice and claims verification against patient's medical reports and maintain confidentiality.
- Responsible for patient demographic, services, billing services in EMR Med-it, Immtrac & Luminaire data entry.
- Responsible for Processing Medicaid for Breast & Cervical Cancer (MBCC) applications and follow-up
- Liaison for all resident and student programs coming through CHS rotations
- Responsible for tracking and report progress on follow-up activities as needed until subcontractor file is complete
- Responsible for program QA chart audits reported Quarterly Performance Measures to contractor
- Responsible for DSHS and HHSC grant, reports, and renewals
DFEET-BCCS Administrative Assistant/Case Manager
Galveston County Health District
11.2007 - 01.2011
- Responsible for providing administrative support for the DFEET/BCCS Breast and Cervical Cancer Programs
- Liaison between multiple subcontractors
- Responsible for managing and obtaining subcontractor credentials and reminded when expiring
- Responsible for invoice and claims verification against patient's medical reports
- Responsible for data entry of patient demographics, and billing services in EMR Med-it
Immunization Case Manager/TVFC Coordinator
Galveston County Health District
2002 - 2007
- Responsible for TVFC Vaccine orders, recruiting and training TVFC providers
- Responsible for completing TVFC Provider chart audits
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements
- Conducted thorough assessments, situations, identifying issues, goals, and necessary interventions
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits of immunizations to clients
- Trained new staff, raising team's overall competency and service delivery standards.
Immunizations Clerk
Galveston County Health District
2000 - 2002
- Registered clients for Texas Vaccine for Children (TVFC) and private vaccines into EMR Twices
- Collected patient's fees and made daily deposits
- Responsible for daily & monthly vaccine inventory reports
- Managed document filing systems to ensure easy retrieval and organization of records
- Managed incoming calls professionally, directing callers to appropriate personnel or taking detailed messages when necessary
- Provided quality clerical support through data entry, document management, email correspondence, and overseeing operation of office equipment
Medicare/Medicaid Claims Clerk
Galveston County Health District
1998 - 2000
- Responsible for Medicare and Medicare claims processing for reimbursement
- Handled returned checks to recoup payments
- Prepared documentation and reports for management review, ensuring all details were accurate and complete
- Ensured compliance with company policies and industry regulations through diligent attention to detail in claims processing
- Prioritized workload efficiently, managing multiple ongoing claims simultaneously without sacrificing accuracy or timeliness
Registration and Cashier Clerk
Galveston County Health District
1996 - 1998
- Registered and verified insurance for patients for 4 C'S medical & Dental services
- Checked in patients in for Medical and Dental appointments
- Processed and collected patient's co-pay fees accurately and efficiently with excellent accuracy levels.
- Provided backup support for other departments when needed
- Ensured compliance with company policies and procedures
Education
GED -
College of The Mainland
Texas City, TX03.1994
Skills
Executive & Administrative support, office management, provider orientation, credentialing, facility liaison for provider rotations, claims verification and processing, medical records charting, data entry, EMR data entry, access, excel, word, outlook, and adobe
Certification
Texas Department of State Health Services Community Health Worker Certification #8990
Texas Notary Public ID #13299199-4
Timeline
Managed Care Quality Coordinator
Coastal Health & Wellness
04.2024 - 01.2025
Credentialing and Privileging Manager
Coastal Health & Wellness
08.2022 - 04.2024
Executive Administrative Assistant
Galveston County Health Ditrict
01.2011 - 08.2022
DFEET-BCCS Administrative Assistant/Case Manager
Galveston County Health District
11.2007 - 01.2011
Immunization Case Manager/TVFC Coordinator
Galveston County Health District
2002 - 2007
Immunizations Clerk
Galveston County Health District
2000 - 2002
Medicare/Medicaid Claims Clerk
Galveston County Health District
1998 - 2000
Registration and Cashier Clerk
Galveston County Health District
1996 - 1998
GED -
College of The Mainland
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