Summary
Overview
Work History
Education
Skills
Timeline
Generic

Keisha Daniels-Murrell

Staten Island,NY

Summary

Proven Credentialing Specialist with a track record of enhancing provider relations and enrollment processes at Anthem Healthcare. Skilled in HIPAA Compliance and adept at fostering management collaboration, I significantly improved credentialing efficiency and compliance. My analytical thinking and decisive leadership have streamlined operations, achieving notable advancements in healthcare administration. Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills. Experienced administrative professional with 25+ years in provider credentialing services. Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans. Successful human resource candidate with expertise in employee recruitment, training and payroll management. Adept at building and maintaining positive relationships with employees and management. Strong organizational skills and committed to adhering to relevant laws and regulations. Dedicated professional eager to create and implement successful strategies to improve organizational efficiency. Adept at utilizing data analysis to provide insights into HR initiatives. Strong communication and interpersonal skills and committed to pursuing best practices related to employee development and retention. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level for the position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

22
22
years of professional experience

Work History

Credentialing Specialist

Anthem Healthcare
  • 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.
  • Received and evaluated applications to look for missing and inaccurate information.
  • Conducted primary source verifications such as background checks and board certifications.
  • Safeguarded confidential provider information by adhering to strict data privacy regulations and company policies.
  • Facilitated communication between departments, resulting in improved collaboration during the credentialing process.

Customer Service Manager

Rickels
  • Resolved customer complaints while prioritizing customer satisfaction and loyalty.
  • Took ownership of customer issues and followed problems through to resolution.
  • Managed a team of customer service representatives, fostering a positive work environment focused on teamwork and collaboration.
  • Reduced customer complaints, proactively addressing issues and implementing effective solutions.

Assistant Store Manager

Fayva Shoe
  • Managed cash registers efficiently, ensuring accurate transactions, balancing drawers daily, and minimizing discrepancies.
  • Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities.
  • Enhanced store appearance for increased sales by maintaining cleanliness and implementing strategic merchandise displays.
  • Rotated merchandise and displays to feature new products and promotions.
  • Assisted the Store Manager in analyzing sales data to identify trends and make informed decisions for improving overall store performance.
  • Mentored new employees on company policies, procedures, and best practices to ensure their success within the organization.
  • Supervised and evaluated staff to help improve skills, achieve daily objectives, and attain advancement.

Institutional Coordinator

Richmond University Hospital
10.2002 - Current
  • Facilitated regular meetings with team members to discuss progress updates, address challenges, and brainstorm solutions for ongoing success.
  • Ensure complete and accurate GMEC memberships, pursuant to ACGME
  • Prepare Annual budget and projection for ACGME annual fee for new and existing programs
  • Maintained detailed records of program activities and participant data, ensuring compliance with internal policies and external regulations.
  • Led training sessions for staff and volunteers, fostering a knowledgeable and cohesive team environment.
  • Organized events and workshops to engage participants, enhancing their learning experience within the program framework.
  • Managed budgets and resources for successful execution of multiple programs simultaneously.
  • Oversees ACGME Annual Data Systems for the Institutional
  • Oversees the compilation of all internal review programs documentation and facilitates dissemination to review team members
  • Maintains records of all accreditations communications and actions
  • Counsels resident and staff reviews on process for conducting program special reviews pursuant to ACGME institutional requirements
  • Oversees the administrative processes and provide counsel to faculty and staff related to GMEC responsibilities
  • Reviews and ensures all IA's and PLA's meet ACGME requirements

Education

Associate of Arts - Psychology

College of Staten Island of The City University of New York
Staten Island, NY
06.2024

Skills

  • HIPAA Compliance
  • Background Checks
  • Provider enrollment
  • Data Management
  • Credentialing oversight
  • Provider Relations
  • Insurance procedures
  • Document Review
  • Facility support
  • Management collaboration
  • Microsoft Office
  • Decision-Making
  • Training and mentoring
  • Analytical and Critical Thinking
  • Organizational Development
  • Clerical Oversight
  • Data Analysis
  • Human Resources Support
  • New Hire Onboarding
  • Human Resources Management Systems
  • Employee Hiring

Timeline

Institutional Coordinator

Richmond University Hospital
10.2002 - Current

Credentialing Specialist

Anthem Healthcare

Customer Service Manager

Rickels

Assistant Store Manager

Fayva Shoe

Associate of Arts - Psychology

College of Staten Island of The City University of New York
Keisha Daniels-Murrell