Credentialing professional with solid expertise in managing and verifying credentials for healthcare providers. Strong focus on team collaboration and achieving results. Reliable and adaptable, meeting organizational standards and compliance requirements. Skilled in data management, regulatory compliance, and communication.
Overview
11
11
years of professional experience
Work History
Credentialing Specialist
OSF Healthcare
11.2023 - Current
Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
Conducted 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.
Facilitated communication between departments, resulting in improved collaboration during the credentialing process.
Received and evaluated applications to look for missing and inaccurate information.
Demonstrated excellent problem-solving skills when confronted with complex issues or discrepancies during the credentialing process.
Expedited the onboarding process for new providers, ensuring timely completion of all required documentation and verifications.
Developed strong relationships with external organizations, leading to increased cooperation during verification processes.
Contributed positively to team dynamics by fostering a collaborative and supportive work environment.
Assisted in training new employees on proper credentialing procedures, contributing to their rapid integration into the team environment.
Coordinated credentialing committee meetings, ensuring productive discussions and decision-making.
Improved provider satisfaction with efficient handling and processing of credentialing applications.
Addressed and resolved discrepancies in provider documentation, maintaining high level of data integrity.
Coordinated with multiple departments to ensure compliance with healthcare regulations, maintaining accreditation standards.
Managed credentialing files with strict adherence to confidentiality and privacy laws, ensuring secure handling of sensitive information.
Patient Access Associate
OSF Healthcare Saint Anthony Medical Center
06.2022 - 11.2023
Supported hospital objectives by participating in quality assurance audits, identifying areas for improvement within the Patient Access department.
Provided exceptional customer service to patients, addressing concerns and answering questions regarding the admissions process.
Collaborated with interdisciplinary teams for improved care coordination, resulting in better patient outcomes overall.
Enhanced communication with medical staff by accurately documenting and sharing patient information in a timely manner.
Enhanced accuracy of demographic data collection by implementing thorough review processes before finalizing registrations or admissions documentation.
Facilitated a smooth billing process by promptly identifying and resolving discrepancies in patient accounts.
Reduced errors in patient registration by meticulously collecting and inputting data into electronic health records.
Boosted overall organization productivity by effectively managing multiple priorities and tasks within a fast-paced hospital environment.
Participated in cross-training initiatives, enhancing the team''s ability to provide comprehensive support across various departments within the hospital setting.
Demonstrated adaptability by readily adjusting to new software systems, policies, or procedures as required for organizational success.
Contributed to increased hospital revenue by diligently verifying insurance coverage and obtaining necessary preauthorizations.
Assisted in maintaining HIPAA compliance by carefully handling sensitive patient information and protecting privacy during interactions.
Ensured seamless coordination of patient appointments, admissions, and discharges through effective communication with various departments and medical professionals.
Upheld the highest standards of professional integrity by maintaining confidentiality and adhering to all relevant healthcare regulations and policies.
Head Cashier
Home Depot
11.2020 - 03.2021
Trained, mentored and developed new cashiers with positive and encouraging techniques to maximize performance and team contributions.
Performed store opening, closing and shift-change actions and kept accurate shift-change logs.
Assisted customers by answering questions and fulfilling requests.
Educated employees on register use, merchandising and customer service.
Helped customers complete purchases, locate items and join reward programs.
Set and updated employee schedules based on expected customer needs to meet coverage demands.
Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies.
Restaurant Hostess
JMK Nippon
10.2018 - 10.2020
Stayed in open communication with kitchen team to assess cooking times, avoid worker overload and minimize customer dissatisfaction.
Answered customer questions about hours, seating and menu information.
Supported servers, food runners and bussers with keeping dining area ready for every guest.
Took reservations and to-go orders by phone, answered customer questions and informed of accurate wait times.
Performed end of shift duties, including complete shut down of the restaurant and tallying of customers and revenue.
Head Server
JMK Nippon
09.2014 - 10.2020
Trained new staff on restaurant operations and policies to strengthen performance.
Modeled strategies to wait staff for delivering exceptional and friendly service to every guest, every time.
Stayed up-to-date on menu changes to help customers make food choices.
Assigned work tasks and coordinated activities of dining room personnel to provide prompt and successful service to patrons.
Used communication and problem-solving skills to resolve customer complaints and promote long-term loyalty.
Supervised server staff and simultaneously served personal section of tables.