Summary
Overview
Work History
Education
Skills
Websites
Timeline
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Ellie Perez

Summary

A highly skilled and detail-oriented Credentialing Specialist with strong critical thinking and problem-solving abilities. Proficient in utilizing various technologies and software to streamline credentialing processes. Extensive knowledge and experience in ABA, SLP, OT, and PT credentialing across all 50 states, ensuring compliance with state-specific requirements and industry standards.

Overview

7
7
years of professional experience

Work History

Credentialing Coordinator

Jade Health
08.2023 - Current
  • Managed efficient and compliant credentialing and contracting processes, ensuring timely and accurate practitioner applications and communication with payors.
  • Organized and maintained practitioner application files for over 35 groups, ensuring all records were up-to-date, accurate, and compliant with internal and external standards.
  • Screened applications and supporting documentation to verify eligibility, identifying discrepancies, and conducting follow-ups to resolve any issues.
  • Submitted applications for Medicaid, commercial payors, and managed care organizations, ensuring compliance with their specific requirements.
  • Coordinated with payors to monitor the status of credentialing/contracting applications, providing regular updates to Credentialing Managers, and submitting any additional required information.
  • Acted as a liaison between the sales team and Credentialing Managers to ensure a seamless transition from the sale of services to the onboarding and credentialing process.
  • Responded to and managed credentialing and contracting verification requests, ensuring accuracy and prompt completion.
  • Provided exceptional customer service by assisting clients with application inquiries and offering clear, informative communication.
  • Proactively identified and recommended process improvements to streamline credentialing operations and enhance customer satisfaction.
  • Assisted with various credentialing-related tasks as directed by the Credentialing Manager.

Secretary

Georgia Pinestraw
08.2022 - 07.2023
  • Processed payroll for employees, ensuring timely and accurate payments, deductions, and compliance with company policies and legal requirements.
  • Managed order dispatching, coordinating the timely and efficient delivery of goods/services to customers.
  • Handled a high volume of customer service inquiries, providing excellent support through phone, email, and in-person communication.
  • Answered phone calls promptly and professionally, addressing customer concerns, questions, and service requests with a positive attitude.
  • Effectively resolved customer complaints, working to address issues and provide appropriate solutions to ensure satisfaction.
  • Collaborated with internal teams to ensure customer needs were met and orders were fulfilled accurately and efficiently.
  • Maintained customer records, ensuring that all interactions and service requests were properly documented for follow-up.
  • Ensured that payroll-related questions or issues from employees were resolved in a timely and professional manner.

Paraeducator, Special Education

Toombs County School
08.2018 - 12.2022
  • Delivered personalized educational, behavioral, and emotional support to individual students to enable positive learning outcomes.
  • Reported on student progress, behavior, and social skills to parents.
  • Assisted classroom teacher in supervising snack time and indoor and outdoor play.
  • Collaborated with teacher to create customized classroom environment integral to students' needs.
  • Assisted students with their acedmic activites
  • Tutored children in Math, Science, ELA and History
  • Worked with children 1st through 7th grade

Education

Toombs County High School
05-2021

Skills

  • Records and file management
  • Data research and analysis
  • Background investigations
  • License verifications
  • HIPAA compliance
  • Practitioner application coordination
  • Provider enrollment
  • Comfortable with technology and proficient in troubleshooting and resolving technical issues

Timeline

Credentialing Coordinator

Jade Health
08.2023 - Current

Secretary

Georgia Pinestraw
08.2022 - 07.2023

Paraeducator, Special Education

Toombs County School
08.2018 - 12.2022

Toombs County High School

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Ellie Perez