Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tereka Guerrero

San Antonio,TX

Summary

Detail-oriented administrative professional with over 20 years of customer service and more than 5 years of experience in provider verification and credentialing support, including direct work with military and government medical facilities. Adept at using CCQAS, databases, and spreadsheets to track, update, and maintain provider credentials in accordance with DHA and regulatory guidelines. Known for accuracy, timeliness, and clear communication with providers, agencies, and healthcare facilities.

Overview

8
8
years of professional experience

Work History

Administrative Assistant – Credentialing

Bestica inc.
04.2023 - Current
  • Complete healthcare provider credentialing requests for military medical facilities, ensuring accuracy and compliance with DHA and DoD guidelines.
  • Cross reference information from incoming request and database with CCQAS.
  • Track application statuses in spreadsheets and databases; perform timely follow-up to meet strict deadlines for MTF and e-application closures.
  • Communicate with medical facilities to obtain missing information.

Medical Benefit Advocate

UnitedHealth Group
10.2018 - 04.2023
  • Verified provider licensing and certifications through internal systems and WPATH to ensure physicians were credentialed to perform gender-affirming procedures.
  • Communicated with physician offices and hospitals to confirm patient records, procedures, and billing codes prior to authorization.
  • Ensured providers were fully credentialed and eligible before authorizing patient care, safeguarding compliance and accurate claims processing.
  • Collaborated with cross-functional teams including pharmacy, medical, and application testing groups to resolve escalated issues.
  • Trained and mentored new advocates.

Client Service Analyst / Data Integrity Specialist Roles

SWBC
06.2017 - 10.2018
  • Tracked foreclosures and ensured compliance timelines.
  • Led data integrity processes, audited reports.
  • Supervised daily team operations, monitored productivity, and ensured timely project completion.

Education

Medical Front Office Certification -

St. Philip’s College
San Antonio, TX
01.2022

Skills

  • Healthcare Credentialing
  • Primary Source Verification (PSV)
  • CCQAS Data Management
  • Provider Records & Privileging
  • DoD & DHA Regulatory Requirements
  • Customer & Provider Communication
  • Data Entry & Documentation Control

Timeline

Administrative Assistant – Credentialing

Bestica inc.
04.2023 - Current

Medical Benefit Advocate

UnitedHealth Group
10.2018 - 04.2023

Client Service Analyst / Data Integrity Specialist Roles

SWBC
06.2017 - 10.2018

Medical Front Office Certification -

St. Philip’s College

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