LATONYA THOMAS-TURNER
2353 Forest Lake Lane, Sterrett,AL
Summary
Highly organized Credentialing Assistant/Specialist with professional experience in healthcare credentialing and privileging processes. Strong understanding of compliance regulations, medical staff services, and administrative support. Demonstrated ability to manage high volume workloads, prioritize tasks, and maintain confidentiality. Previous role involved improving efficiency in credentialing procedures resulting in streamlined operations..
Overview
14
14
years of professional experience
Work History
Credentialing Assistant
St. Vincent's Health System
Birmingham, AL
02.2020 - Current
- Process and maintain credentialing and recredentialing for physicians and allied health providers in accordance with the Joint Commission.
- Receive and evaluate initial and reappointment applications to look for complete and accurate information.
- Conduct primary source verifications, such as background checks, education, and medical licenses.
- Ensure compliance with accreditation standards and legal requirements related to Medical Staff
- Communicate daily with office managers and medical staff.
Credentialing Coordinator
Select Medical
Birmingham, AL
10.2018 - 02.2020
- Processed medical staff initial and reappointment applications
- Ensured compliance with applicable laws, regulation and procedures and policies
- Performed primary source verification of credentials according to department policy
- Performed Quality Assurance on practitioners' application
- Communicated daily with Health Information Managers (HIM)
E-Content Analyst
EBSCO Industries
Birmingham, AL
07.2017 - 03.2018
- Performed Global Knowledge Base package maintenance activities meeting the departmental key performance indicators
- Communicated with publishers to resolve customer service requests, obtain necessary metadata needed to maintain the Global Knowledge Base, and additional issues as needed
- Conducted regular analysis of publisher supplied data and content feeds to ensure comprehensiveness, quality, and accuracy of the metadata
- Participated and contributed in team wide initiatives related to the quality of the Global Knowledge Base as needed
- Resolved issues using researching and critical thinking skills
Enrollment/HealthCare Quality Assurance Specialist
DST Health Solutions
Birmingham, AL
08.2013 - 07.2017
- Conducted audits on associates referencing documented policies and procedures
- Created department desktop procedures for audit plan
- Mentored less experienced associates
- Performed quality review of all functions/tasks performed within the enrollment department
- Maintained a positive working relationship with supervisors, team members, clients and other cross functional departments
- Participated in the development of Quality Assurance plans
- Responsible for daily reconciliation of beneficiary's membership
- Processed urgent requests from the client and other departments
- Served as a resource to other members of the Enrollment team
- Processed inquiries from the Customer Service Department
- Monitored and maintained daily processing of the Transaction Reply Report (TRR) and Monthly Membership Report (MMR) from the Centers for Medicare and Medicaid Services (CMS)
- Completed retroactive enrollment and disenrollment process
- Assisted with special projects as needed
- Reconciled monthly claim reports
- Provided accurate research
Credentialing Specialist
Princeton Baptist Medical Center
Birmingham, AL
02.2011 - 08.2013
- Maintained credentialing database and tracked all physicians and allied health professional data
- Assured credentialing, reappointment, and privilege were completed in accordance with Medical Staff bylaws, rules & regulations and, Joint Commission, NCQA, federal/ state standards/requirements
- Prepared files for presentation to the Chief Medical Officer, Medical Executive and Credential Committee
- Recorded minutes from committee and department meetings
- Audited files for completed information upon submission and, request missing data from physician
- Maintained strict confidentiality of company & personnel information
- Demonstrated a strong commitment to the mission and values of the organization
- Provided support to executive management
- Articulated knowledge and understanding of the medical staff rules & regulations and bylaws
- Prepared agendas for medical staff meetings
- Prepared monthly emergency room call schedules
- Performed general clerical duties
- Performed other duties and worked on special projects as requested
Education
Associate of Applied Science - Business
Virginia College at Birmingham
Birmingham, AL01.1997
Skills
- Communication
- Problem solving
- Teamwork
- Organizational
- Attention to detail
- Time management
- Work ethic
- Computer skills
Timeline
Credentialing Assistant
St. Vincent's Health System
02.2020 - Current
Credentialing Coordinator
Select Medical
10.2018 - 02.2020
E-Content Analyst
EBSCO Industries
07.2017 - 03.2018
Enrollment/HealthCare Quality Assurance Specialist
DST Health Solutions
08.2013 - 07.2017
Credentialing Specialist
Princeton Baptist Medical Center
02.2011 - 08.2013
Associate of Applied Science - Business
Virginia College at Birmingham
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