Joe A. Nunez Jr.
Bastrop,TX
Summary
Results-driven credentialing coordinator with13 years of experience in provider enrollment, credentialing, and data entry. Proficient in various databases, including MDStaff, Modio Health, Symplr, Kareo, Credential Stream, Med Trainer, Medallion, OneApp and CAQH. Proven track record of ensuring compliance with industry standards and providing excellent customer service. Possess a strong background in medical office experience, HIPAA, and medical billing. Skilled in office management, human resources, and employee orientation. Seeking a remote opportunity that leverages my expertise in credentialing and data entry.
Overview
25
25
years of professional experience
Work History
Engineer Test Assistant (Temp)
Aston Carter (Hewlett Packard POLY)
02.2024 - Current
- Assisted engineers in the design and development of new products, ensuring adherence to project specifications
- Conducted research and gathered data to support engineering projects, contributing to informed decision-making
- Performed quality control checks on prototypes and final products to ensure compliance with industry standards
- Collaborated with cross-functional teams to coordinate project timelines and deliverables
- Supported engineers in troubleshooting technical issues during product testing phases
- Conducted experiments under the guidance of senior engineers to validate hypotheses or test new technologies/processes
Data Entry Specialist (Temp)
Aston Carter (CommunityCare)
10.2022 - 01.2024
- Entered and verified data accurately into company database, ensuring data integrity
- Performed regular audits of data entries to identify and correct errors, maintaining a high level of accuracy
- Created and updated spreadsheets with large volumes of data, organizing information for easy retrieval
- Maintained confidentiality and security of sensitive information by following established protocols
- Collaborated with team members to resolve discrepancies or missing information in the database
- Collaborated with IT department to troubleshoot any technical issues related to the database or software used for data entry
- Communicated effectively with other departments or clients to clarify any unclear or incomplete information before entering it into the system
- Maintained an organized filing system for physical documents related to the entered data
- Managed multiple projects simultaneously while meeting strict deadlines for data entry tasks
Credentialing & Provider Enrollment Coordinator
The Hospital at Westlake Medical Center & ARISE Austin Medical Center
12.2020 - 09.2022
- Managed the credentialing process for a team of over300 healthcare professionals, ensuring compliance with industry standards and regulations
- Collaborated with HR department to verify credentials and qualifications of potential hires, ensuring only qualified candidates were considered for employment
- Maintained accurate records of all staff credentials, licenses, certifications, and continuing education requirements
- Conducted regular audits to ensure ongoing compliance with accrediting bodies' standards and requirements
- Served as a liaison between healthcare providers and insurance companies to resolve any credentialing issues or discrepancies
- Implemented an electronic database system for storing and tracking all credentialing documents, improving efficiency and accessibility
- Coordinated with medical staff offices to obtain necessary documentation for initial appointments and reappointments
- Reviewed applications for completeness and accuracy, following up with applicants as needed to gather missing information or clarify details
- Closely monitored expiration dates of licenses, certifications, malpractice insurance policies, etc., sending timely reminders for renewal or updating as required
- Maintained strong relationships with external agencies such as state licensing boards and professional associations to stay updated on changes in regulations or requirements
- Demonstrated expertise in interpreting complex regulatory guidelines related to provider enrollment processes across multiple payers (Medicare/Medicaid/Commercial)
- Leveraged technology tools such as CAQH ProView or similar systems for efficient data collection during the provider enrollment process
- Collaborated with IT department to develop customized reports and dashboards for tracking key metrics related to provider enrollment status and timelines
- Liaised with external auditors during accreditation surveys or audits related to provider enrollment processed
Credentialing & Provider Enrollment Specialist
OrthoLoneStar (Formerly TX OrthoTechs)
11.2019 - 10.2020
- Managed the credentialing & provider enrollment processes for a large healthcare organization, ensuring timely and accurate completion of all required applications
- Reviewed and verified provider applications, credentials, and supporting documents to ensure compliance with regulatory requirements
- Maintained up-to-date knowledge of state and federal regulations related to provider enrollment and made necessary updates to internal processes
- Collaborated with various departments including credentialing, billing, and legal teams to resolve any issues or discrepancies in provider applications
- Performed regular audits of enrolled providers' information to ensure accuracy and completeness in accordance with organizational standards
- Assisted in the development of training materials for new staff members joining the provider enrollment team
- Acted as a subject matter expert on payer-specific requirements related to provider enrollments, providing guidance to both internal teams and external providers
- Resolved complex issues related to missing or incomplete documentation through thorough research, follow-up calls, emails, or written correspondence
- Maintained accurate records of all communications with providers regarding their application status or additional documentation needed
- Identified opportunities for process improvement within the provider enrollment workflow based on feedback from stakeholders
- Created comprehensive reports detailing key metrics such as application turnaround time, error rates, pending applications etc
- That were used by leadership team
- Provided guidance to providers on required documentation needed for enrollment, ensuring compliance with regulatory standards
Provider Enrollment Specialist (Temp)
Aston Carter (Sendero Healthcare)
11.2018 - 03.2019
- Reviewed and verified provider applications, credentials, and supporting documents to ensure compliance with regulatory requirements for Sendero
- Maintained up-to-date knowledge of state and federal regulations related to provider enrollment and made necessary updates to internal processes
- Developed strong relationships with providers to facilitate open communication and address any concerns or questions regarding the enrollment process
- Performed regular audits of enrolled providers' information to ensure accuracy and completeness in accordance with organizational standards
- Resolved complex issues related to missing or incomplete documentation through thorough research, follow-up calls, emails, or written correspondence
- Maintained accurate records of all communications with providers regarding their application status or additional documentation needed
Executive Assistant to CEO (Temp Contract)
Post-Acute Medical-Round Rock
08.2018 - 09.2018
- Provided high-level administrative support to executive team, managing calendars, scheduling meetings, and coordinating travel arrangements
- Prepared and edited correspondence, reports, and presentations for executive team using Microsoft Office Suite
- Managed confidential information with utmost discretion and maintained strict confidentiality protocols
- Screened phone calls and emails for executives, prioritizing messages and responding on their behalf when necessary
- Organized and facilitated meetings, including preparing agendas, taking minutes, and distributing meeting materials
- Coordinated logistics for company events such as conferences, seminars, and off-site retreats
- Developed efficient filing systems to ensure easy retrieval of documents both in physical files and electronic databases
- Managed expense reports for executives by accurately tracking expenses, reconciling receipts, and submitting timely reimbursement requests
- Assisted in the preparation of budgets by gathering financial data from various departments within the organization
- Collaborated with cross-functional teams to coordinate projects or initiatives led by the executive team
- Maintained a professional image of the executive office through effective communication with internal staff members as well as external stakeholders such as clients or vendors
- Coordinated complex travel itineraries including flights accommodations ground transportation visas etc
- Planned organized coordinated corporate events including conferences seminars workshops etc
- Created detailed expense reports ensuring accuracy compliance with company policies guidelines
- Handled sensitive confidential information discretion integrity safeguarding privacy at all times
Credentialing & Provider Enrollment Specialist
TX Women's Health (Formerly Central TX ON GUN)
04.2017 - 06.2018
- Managed all initial & reappointment applications for over70 providers
- Managed the provider enrollment process for a large healthcare organization, ensuring timely and accurate completion of all required documentation
- Reviewed and verified provider applications, credentials, and supporting documents to ensure compliance with regulatory requirements
- Maintained up-to-date knowledge of state and federal regulations related to provider enrollment and made necessary updates to internal processes
- Collaborated with various departments including credentialing, billing, and legal teams to resolve any issues or discrepancies in provider applications
- Maintained accurate records of all communications with providers regarding their application status or additional documentation needed
- Created comprehensive reports detailing key metrics such as application turnaround time, error rates, pending applications etc
- That were used by leadership team
- Managed a high volume of provider applications simultaneously while meeting strict deadlines and maintaining accuracy
Data Entry Expert (Temp)
Goodwill Staffing Services
06.2016 - 03.2017
- Entered and verified data accurately into company database, ensuring data integrity
- Performed regular audits of data entries to identify and correct errors, maintaining a high level of accuracy
- Maintained confidentiality and security of sensitive information by following established protocols
- Created and updated spreadsheets with large volumes of data, organizing information for easy retrieval
- Collaborated with team members to resolve discrepancies or missing information in the database
- Managed multiple projects simultaneously while meeting strict deadlines for data entry tasks
- Ensured compliance with company policies and industry regulations regarding data privacy and security
- Identified opportunities for process improvement within the data entry workflow, leading to streamlined operations
- Trained new employees on proper procedures for accurate and efficient data entry
- Maintained up-to-date knowledge of relevant software applications used for effective management of data entry tasks
- Performed regular backups of the database to prevent loss of critical information due to technical issues or system failures
Credentialing & Provider Enrollment Coordinator
Easter Medical Staffing
02.2008 - 05.2016
- Managed the credentialing process for a caseload of XX healthcare professionals, ensuring compliance with industry standards and regulations
- Reviewed and verified documentation submitted by healthcare providers to ensure accuracy and completeness
- Maintained up-to-date knowledge of credentialing requirements and changes in regulations to ensure adherence to best practices
- Collaborated with internal departments such as HR, Compliance, and Legal to gather necessary information for credentialing purposes
- Performed primary source verification of education, training, licensure, certifications, work history, malpractice claims history, and other relevant credentials
- Developed and maintained relationships with external organizations such as licensing boards and professional associations to facilitate the credentialing process
- Conducted background checks on healthcare providers using various databases and resources
- Identified discrepancies or red flags in provider applications or documents through thorough review and investigation
- Communicated effectively with healthcare providers regarding missing or incomplete documentation required for credentialing
- Ensured timely completion of all aspects of the credentialing process within established deadlines Maintained accurate records of all provider credentials in compliance with organizational policies and procedures
- Developed strong working relationships with licensing boards & professional associations
- Performed primary source verification on education/training/licensure/certifications/work history/ malpractice claims
- Maintained accurate records/documentation according to organizational policies/procedures
- Conducted background checks using various databases/resources
- Streamlined processes resulting in improved efficiency/accuracy within the department
Military Service
U.S. Marine Corps
10.1999 - 10.2003
- Managed logistics operations including transportation, supply chain management, and equipment maintenance for a battalion of800 Marines
- Conducted risk assessments and implemented safety protocols to ensure compliance with military regulations during training exercises
- Maintained accurate records of personnel training certifications, medical evaluations, and security clearances for a base-sized unit
- Performed regular inspections of equipment to identify deficiencies or malfunctions; coordinated repairs or replacements as necessary to maintain operational readiness
- Obtained certification in Administrative, Clerical & Human Resources (Associates Equivalent)
Education
Administrative, Clerical & Human Resources Certification - Associates Degree Equivalent
U.S. Marine Corps School of Support Services - Camp Johnson
NC07.2000
Diploma - undefined
Elgin High School
Elgin, TX05.1996
Timeline
Engineer Test Assistant (Temp)
Aston Carter (Hewlett Packard POLY)
02.2024 - Current
Data Entry Specialist (Temp)
Aston Carter (CommunityCare)
10.2022 - 01.2024
Credentialing & Provider Enrollment Coordinator
The Hospital at Westlake Medical Center & ARISE Austin Medical Center
12.2020 - 09.2022
Credentialing & Provider Enrollment Specialist
OrthoLoneStar (Formerly TX OrthoTechs)
11.2019 - 10.2020
Provider Enrollment Specialist (Temp)
Aston Carter (Sendero Healthcare)
11.2018 - 03.2019
Executive Assistant to CEO (Temp Contract)
Post-Acute Medical-Round Rock
08.2018 - 09.2018
Credentialing & Provider Enrollment Specialist
TX Women's Health (Formerly Central TX ON GUN)
04.2017 - 06.2018
Data Entry Expert (Temp)
Goodwill Staffing Services
06.2016 - 03.2017
Credentialing & Provider Enrollment Coordinator
Easter Medical Staffing
02.2008 - 05.2016
Military Service
U.S. Marine Corps
10.1999 - 10.2003
Administrative, Clerical & Human Resources Certification - Associates Degree Equivalent
U.S. Marine Corps School of Support Services - Camp Johnson
Diploma - undefined
Elgin High School