Gwendolyn Armendariz
Portland
Summary
Dynamic and results-driven administrative professional with over 8 years of experience in healthcare, specializing in provider credentialing and patient services. Proven track record of enhancing operational efficiency, reducing costs, and boosting customer satisfaction through exceptional relationship-building, problem-solving, and communication skills. Adept at navigating complex application requirements for government and private insurance plans while maintaining professionalism in high-pressure environments. Seeking to leverage extensive expertise and acquire new skills within a reputable organization that values dedication to excellence and continuous improvement.
Overview
6
6
years of professional experience
Work History
Credentialing Specialist I
PeaceHealth
11.2024 - 11.2025
- Maintained 100 percent on all Audits from delegated payors
- Analyzed provider applications to ensure compliance with regulatory standards and organizational policies.
- Coordinated with cross-functional teams to facilitate timely credentialing of healthcare professionals.
- Monitored and maintained databases for credentialing information, ensuring data integrity and security.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Conducted 100 percent accuracy audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
Medical Staff Credentialing Coordinator
Duly Health and Care
05.2022 - 10.2024
- I was responsible for organizing, maintaining, and verifying that all staff have appropriate accreditations at a healthcare.
- Keeping detailed records of medical staff members, maintaining databases and ensuring staff members possess legal licenses and credentials to work in their specialties.
Credentialing Coordinator
SonderMind
01.2021 - 06.2023
- Maintain compliance with all regulatory and accrediting institutions
- Monitor staff credentials and licenses
- Advise staff on renewal procedures
- Participate in the development of internal credentialing processes
- Keep records in licenses, credentials and insurance contracts
- Release information to agencies and members of the public as required
- Coordinated credentialing processes for new providers, ensuring compliance with regulatory standards.
- Streamlined verification procedures, enhancing efficiency in onboarding workflows.
Senior Credentialing Specialist
District Medical Group
03.2020 - 05.2022
- Maintain compliance with all regulatory and accrediting institutions
- Monitor staff credentials and licenses
- Advise staff on renewal procedures
- Participate in the development of internal credentialing processes
- Keep records in licenses, credentials and insurance contracts
- Release information to agencies and members of the public as required by law
- Managed credentialing processes for healthcare providers, ensuring compliance with regulatory standards.
- Facilitated primary source verification of licenses and certifications to maintain accuracy in provider credentials.
Education
Bachelor's degree - Healthcare Management
CTU Online
Aurora, CO11-2028
Associate - Science (AS)
Portland Community College
Portland, OR05.2008
Skills
- Revenue cycle optimization
- Electronic health records (EHR) management
- Healthcare administration experience
- Healthcare compliance -experience (6-10 years
- Insurance eligibility verification
- Salesforce
- Knowledge of NCQA standards
- Epic
- Quality control
- Cerner proficiency
- Medicare
- Compliance management
- Application processing
- Record maintenance
- Credential verification
Timeline
Credentialing Specialist I
PeaceHealth
11.2024 - 11.2025
Medical Staff Credentialing Coordinator
Duly Health and Care
05.2022 - 10.2024
Credentialing Coordinator
SonderMind
01.2021 - 06.2023
Senior Credentialing Specialist
District Medical Group
03.2020 - 05.2022
Associate - Science (AS)
Portland Community College
Bachelor's degree - Healthcare Management
CTU Online