LaSheanne Nelson
Gilbert,AZ
Summary
Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
13
13
years of professional experience
Work History
Family Support Specialist/Credentialing Specialist
Branching Out Family Services
09.2022 - Current
- Established meaningful connections with families, delivering service coordination, support, and training to foster children's development and empower parents
- Successfully managed provider onboarding and liaised with DDD support coordinators to ensure accurate documentation and service hour compliance
- Conduct credential audits, managed timesheets, and resolved discrepancies to ensure accurate compensation for providers
- Proactively addressed social isolation and enhanced relational capacity through trust-building initiatives with parents and youth
- Developed innovative solutions to diverse family needs, consistently exceeding expectations
- Utilized project management tools and methodologies to streamline processes and improve project efficiency
- As a credential specialist, entrusted with the meticulous evaluation of provider credentials for adherence to DDD policies, meticulously verifying accuracy and completeness
- This includes the proactive initiation of recredentialing processes, liaising with both internal stakeholders and external agencies to ensure timely processing and termination as necessary
- Maintaining the integrity of our credentialing database, meticulously updating records to reflect current credentials and expirations
- Undertake proactive monitoring of credential expiration dates, preemptively reaching out to providers with timely reminders well in advance of deadlines, ensuring uninterrupted service provision.
Intake Coordinator
Lifeline PCS
05.2021 - 09.2022
- Conducted thorough patient interviews and completed admissions paperwork with precision and accuracy
- Verified patient insurance coverage and benefits, facilitating seamless financial processes
- Efficiently scheduled appointments and managed administrative tasks to support effective healthcare service delivery
- Maintained meticulous patient records and performed data entry into Clinic Tracker, ensuring compliance with record-keeping standards
- Collaborated with colleagues to deliver exceptional customer service and resolve patient inquiries promptly.
Virtual Teacher Assistant
Legacy Traditional Schools
01.2021 - 05.2021
- Provided invaluable support to online students, including grading and communication with parents to ensure a positive learning experience
- Enforced school and class rules, promoting a culture of positive behavior among students
- Prepared instructional materials, participated in staff meetings, and upheld instructional and safety standards to facilitate effective learning environments
- Fostered positive relationships with students and staff, contributing to a cohesive and supportive learning community.
Customer Service Representative
CVS Health
08.2019 - 05.2020
- Assisted members with pharmacy benefit plans, addressing prescription insurance, coverage, and mail order inquiries
- Offered tailored solutions to simplify members' healthcare experiences, enhancing overall customer satisfaction
- Collaborated with colleagues to deliver quality customer experiences, resolving issues promptly and effectively
- Demonstrated proficiency in navigating multiple computer systems and search tools to provide accurate information.
Paraprofessional
Casa Grande Union High School District
10.2017 - 08.2019
- Provided invaluable support to student learning through effective communication, tutoring, and classroom management
- Mentored struggling students, offering explanations and guidance on class materials to promote academic success
- Assisted with attendance and classroom management, contributing to a positive and conducive learning environment
- Maintained order during transitions and unstructured times, ensuring a smooth and efficient school experience.
Behavioral Health Paraprofessional
Park Place Outreach & Counseling Inc
08.2017 - 12.2018
- Provide direct care to behavioral health patients
- Conduct patient safety checks
- Assist in maintaining a safe, orderly, and therapeutic environment
- Recognize and react appropriately to patients displaying aggressive behavior, acting as a danger to themselves or others, or are in a crisis or medical emergency
- Chart observations according to facility policy and procedure
- Be receptive to guidance and direction from Lead Behavioral Health Technicians or Site Supervisor
- Assists in admitting and discharging patients by performing contraband checks and accurately documenting patient belongings for discharge return.
Family Manager / Stay at Home Mom
06.2015 - 08.2017
- Developed activities to foster empathy
- Balanced daily routines, including school activities, sports, and personal care
- Managed household tasks such as budgeting, meal planning, and scheduling
- Cleaning and keeping the home tidy
- Helping the children with their homework
- Taxiing the children around from place to place
- Looking after the family pets.
Caregiver
Horrigan Enterprises
04.2011 - 06.2015
- Offering companionship to patients
- Taking clients to their medical appointments, the grocery store, and other important places
- Managing medication
- Keeping proper care records
- Preparing meals when needed
- Providing care across a variety of settings, including group homes and day service programs
- Keeping the house clean and doing laundry when needed
- Communicating with medical professionals about the patient care plan
- Maintaining a safe and comfortable home environment
- Providing bathing and dressing assistance
- Encouraging socialization and participation in community activities.
Education
Bachelor of Science in Sociology - Social Work
Grand Canyon University
Phoenix, AZ05.2024
Skills
- Project Management
- Credentialing and Compliance
- Service Coordination
- Relationship Building
- Time Management
- Compliance Auditing
- Communication
- Data Management
- Problem-Solving
- Individualized Service Planning
- Professional boundaries
- Self-awareness
- Motivational Interviewing
- Multicultural Sensitivity
- Family Dynamics
- Behavioral support
- Community Resources
- Client Advocacy
- Interpersonal Relationships
- Incident Management
- Case Management
- Client Education
- Interagency collaboration
- Report Generation
- Client documentation
- Family Support
- File Management
- Microsoft Office Suite
- High-Risk Populations Identification
Timeline
Family Support Specialist/Credentialing Specialist
Branching Out Family Services
09.2022 - Current
Intake Coordinator
Lifeline PCS
05.2021 - 09.2022
Virtual Teacher Assistant
Legacy Traditional Schools
01.2021 - 05.2021
Customer Service Representative
CVS Health
08.2019 - 05.2020
Paraprofessional
Casa Grande Union High School District
10.2017 - 08.2019
Behavioral Health Paraprofessional
Park Place Outreach & Counseling Inc
08.2017 - 12.2018
Family Manager / Stay at Home Mom
06.2015 - 08.2017
Caregiver
Horrigan Enterprises
04.2011 - 06.2015
Bachelor of Science in Sociology - Social Work
Grand Canyon University
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