

Senior Credentialing Operations Specialist with 9+ years of healthcare administration experience specializing in provider credentialing, compliance management, and operational support. Proven expertise in maintaining practitioner files in compliance with NCQA and HIPPA standards, supporting audits, improving workflow efficiency, and ensuring data accuracy. Highly detail-oriented professional with strong leadership, communication, and remote work capabilities.
- Managed end-to-end credentialing processes for healthcare practitioner, ensuring compliance with NCQA and HIPPA standards.
- Maintained accurate and audit-ready practitioner files, reducing compliance discrepancies.
- Verified licensure, certifications, malpractice coverage, and provider documentation.
- Supported successful internal and external audits through detailed record organization.
- Improved workflow efficiency through data tracking and spreadsheet reporting.
- Coordinated communication between providers, internal departments, and external partners.
- Provided administrative oversight including scheduling, documentation preparation, and operational reporting.
- Assisted customers with reservations and ticketing services.
- Resolved customer concerns professionally and efficiently.
- Maintained high service standards in a fast-paced environment.
- Strengthened communication and conflict resolution skills.