Felicia Perkins
Nashville,USA
Summary
Experienced with credentialing healthcare providers and maintaining compliance across various regulatory standards. Utilizes data management and analytical skills to enhance credentialing accuracy and efficiency. Track record of building effective relationships with healthcare providers and team members.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Provider Credentialing Consultant- Contract
Delta Dental of California
12.2024 - Current
- Participate actively in the development and implementation of policies and procedures related to credentialing processes, ensuring alignment with industry best practices.
- Enhance compliance with industry standards through meticulous assessment of provider qualifications and credentials.
- Support high-quality patient care by ensuring only qualified providers were admitted into networks.
- Ensure accurate provider data entry, contributing to the maintenance of up-to-date records for all healthcare professionals.
- Collaborated with medical staff services to streamline communication and facilitate a smooth credentialing experience for providers.
CREDENTIALING ANALYST
Denta Quest
02.2021 - 12.2024
- Manage provider credentialing process for a network of over 300 physicians and allied health and Dental professionals, ensuring compliance with organizational policies and regulatory requirements.
- Conduct primary source verification of provider credentials, including education, licensure, board certification, and malpractice history.
- Collaborate with the credentialing committee to review and make recommendations on provider applications for appointment and reappointment.
- Implement improvements to credentialing processes, resulting in a 20% reduction in processing time.
- Train new staff members on credentialing procedures and use of credentialing software.
- Streamlined the credentialing process by implementing efficient tracking systems and maintaining accurate records.
CLINICAL CREDENTIALING DENTAL SPECIALIST
Smile Direct Club
02.2019 - 07.2021
- Assisted in the credentialing and privileging of Dentist and Dental professionals along advanced practice providers, maintaining accurate records in credentialing databases.
- Conducted audits of provider files to ensure compliance with organizational and accrediting body standards.
- Managed a portfolio of accounts across various industries, including healthcare, technology, and manufacturing, to drive client satisfaction and retention.
- Developed and executed comprehensive account plans to achieve revenue targets and increase market share within assigned territories.
- Collaborated with internal teams to deliver product demonstrations, training sessions, and presentations to clients, resulting in a 80-100 % increase in client engagement and satisfaction.
- Prepared credentialing files for review by credentialing committee and medical executive committee.
- Coordinated with insurance carriers and managed care organizations to ensure provider participation and credentialing compliance.
- Set up and organized dental facilities in 6 different fields.
BUSINESS CREDENTIALING SPECIALIST
Meharry Medical College
10.2015 - 05.2019
- Validates completeness of provider, students and dental schools applications prior to processing.
- Conducts primary source verification for all credentialing and re-credentialing applications.
- Monitors the progress and completion of all site visits by the provider network team to ensure completion within the established timeframe.
- Accurately enters all critical data elements of provider applications into the Credentialing system.
- Responds to email/phone inquiries received into the Credentialing phone queue from internal and external clients.
- Complete task by deadlines.
Education
Bachelor of Science - Business Management
University of Phoenix
Nashville03.2010
Associate of Science - Dental Assisting
High Tech Institute
Nashville08.2007
Skills
- Knowledge of Credentialing Standards : NCQA, URAC, CAQH
- Organizational Skills, and Joint Commission requirements
- Dental Software: Open Dental, Eagle Soft, Dentrix,and Denticon
- Effective Communication
- Problem-Solving Abilities
- Data Management Expertise
- CRM and Service Proficiency
- Contract Analysis and Management
- Credentialing software proficiency
- Attention to Detail
- Compliance Knowledge
Certification
- Certified Coronal Polishing
- Registered Nitrous Monitoring Certification
Timeline
Provider Credentialing Consultant- Contract
Delta Dental of California
12.2024 - Current
CREDENTIALING ANALYST
Denta Quest
02.2021 - 12.2024
CLINICAL CREDENTIALING DENTAL SPECIALIST
Smile Direct Club
02.2019 - 07.2021
BUSINESS CREDENTIALING SPECIALIST
Meharry Medical College
10.2015 - 05.2019
Bachelor of Science - Business Management
University of Phoenix
Associate of Science - Dental Assisting
High Tech Institute