Lydia Bojorquez

Greeted students at counter.

Provide support with the daily operation of production, preparation, and sales of breakfasts and lunches
Distribute, assemble, heat, and serve breakfast and lunch to students and staff
Maintain the flow of meals from oven to serving areas, ensuring timely service of food
Dispense and package individual servings of food by working at conveyor tables, opening cans, and operating kitchen equipment
Order, receive, stock, store, and rotate foods and supplies
Clean work areas, counters, tables, utensils, trays, pots, pans, and kitchen equipment.
Keep storage rooms, refrigerators, and freezers organized, clean and sanitary
Operate a computerized automated sales system
Count money and make accurate change
Count and record daily cash receipts
Total daily sales and prepare deposits for monies received
Organize serving areas, including but not limited to setting up and taking down service areas
Set up and stock assembly lines; load/unload serving carts
Unload/load equipment in preparation for transport to different locations throughout the District
Review free and reduced-price meal applications for completeness
Assist with the distribution of food for special occasions and catering events
Provide support with the review of recipes and menus to estimate quantities of food/means to be ordered or prepared
Assist with guidance, training, and support of Food Service Professional staff
May troubleshoot and resolve problems with computer software systems and kitchen equipment
Prepare, maintain, and update a variety of documents, reports, files, and databases related to assigned activities
Establish and maintain professional relationships with management, colleagues, staff, and school-related outside agencies

• Follow up with practitioners regarding initial, reappointment applications, and fees
• Review initial applicants in MD-App
• Review applications and other documents for completeness and initiate verifications
• Process resignations
• Expirables follow-up
• Obtain Activity reports and proctoring summaries from physician's affiliations when needed
• Run NPDB queries, state sanctions, Medicare exclusions list
• Provide administrative support to the Credentials Committee, creating a monthly calendar, meeting invitations, tracking attendants, placing catering orders, setting up phones and tablets for meetings, printing agendas, etc
• Create physician's packets for file review
• Create Board letters for the Chief of Staff to sign
• Scan, upload board letters into MD-Staff
• Mail Board Letters to practitioners
• Maintain and update the practitioners information into the database
• Support other competency management functions such as proctoring evaluation requests by bylaws, rules and regulations, and policies and procedures
• Effectively communicate issues and ongoing status of assigned work to the Director
• Upload monthly calendar, practitioners' rosters, ER call panels, Bylaws and Regulations into the intranet

• Assist with preparation of pre-delegation credentialing audits
• Review, process, and score credentialing delegation audits
• Send audit result notification letters
• Responsible to maintain quarterly reports up to date
• Responsible to maintain delegation calendar up to date
• Assist with reviewing and processing of annual and monthly regular group audits
• Review, and process provider credentialing applications according to NCQA regulations, LIBERTY Policy and Procedures, and all state and federal regulations
• Ensure timely processing of credentialing requests
• Work with outsourced CVO and staff to accomplish credentialing status
• Review and update CVO Outstanding and Expirable credentialing reports
• Data entry, scanning, emailing, faxing, phone calls, printing, mailing, etc
• Assist with updates to credentialing log as needed
• Serve as main contact for all Dental Service Organizations (DSOs) assigned to credentialing: receive and print submitted credentialing applications, follow up and acquire missing documents, respond to email questions, and forward materials to Provider Relations Department for review and/or activation

• Process initial and re-credential applications thru Evips
• Review and update providers' credentials through CVO site
• Update credentialing information in HSP/Meditrac, and Access database
• Place credentialing requests to offices or providers
• Follow up on missing provider's documentation
• Perform primary source verification through State Boards, DEA, OIG, SAM, CMS DATA GOV, OMIG, NPPES
• Assists with credentialing projects, researching and preparing other reports

• Enter and maintain Provider applications, contracts and updates into the system
• Serve as liaison between provider and hospitals
• Enter and maintain all Provider information into credentialing database
• Verify potential and existing Provider's license, liability insurance, CDS and DEA certificate, Etc.…
• Contact providers for required or missing information
• Complete Provider's hospitals applications to apply for initial or reappointment
• Review and sent provider package to hospitals (hospitals application & required documentation)
• Follow up with the hospitals regarding provider status
• Verify Provider's education, hospital privileges, Board certification and other criteria as required
• Perform ongoing research to correct data so it does not create duplicate provider, locations, payees, and participation
• Maintain credentialing information by reviewing, entering and following up on missing information
• Review National Practitioners Data Bank for adverse charges pending or filed against Provider
• Track contract applications status
• Assure all files have a Welcome, Denial or Term Letter as appropriate
• Meet required turnaround times
• Keep up to date provider privileges process and records and track provider participation levels
• Update the system and the credentialing database to reflect approvals, denials and/ or terminations
• Assist with other duties as assigned

• Process Pharmacists Initial Credentialing & Re-credentialing applications
• Analyze Information based on company policy and credentialing regulations
• Perform primary source verifications through State Boards websites, DEA website, OIG, NPDB, AMA, etc.…
• Running status reports
• Tracking expirable credentials
• Obtain outstanding credentialing documentation
• Update Credentialing information in Access database
• Review and update claims information
• Prioritize work to meet goals & objectives
• General clerical work such as faxing & scanning

• Review of credentialing applications and other pertinent documents
• Customer service regarding contracts inquiries, claim questions, credentialing issues
• Monitoring Expiration dates of time-sensitive credentials
• Obtain missing credentialing documentation
• Responsible for overall provider TRICARE contracts and amendments
• Draft agreements and amendments outlining contractual terms
• Loading and processing documents using various databases
• (ACCESS, EMPTORIS, ORACLE & AS 400)
• Create and submit electronic change forms for new agreements, terminations, demographic changes, and new tax identification numbers
• Structure and billing set-up in AS 400
• Preparation of plan materials such as administrative documents and TRICARE provider education materials
• Review rates and clauses to verify their accuracy
• Verification of executed contracts to make sure they are accurately entered and implemented
• Customer service regarding contracts inquiries, claim questions, credentialing issues

• Process routine re-credentialing requests to include providing current documents and current attestation statements
• Complete & Process applications/contracts for DHMO/PPO/RFFS dental plans
• Send applications to dentist for signature, and follow-up regarding outstanding items
• Review applications for accuracy and completeness
• Serve as liaison to dental plans on behalf of the dental offices
• Coordinate site reviews & Office orientation with dental plans
• Respond to inbound mail (up to thirty pieces per day)
• Complete monthly access survey requests Notify dental plans of dentist hires, terminations, and location changes, as well as PC, DBA, and TIN changes
• Re-contract an office with all applicable dental plans, when it has a new owner, new managing dentist, or new PC Serve as custodian of all contracting packets (by state); supply new forms to outside vendor as necessary

• Ensure accurate and timely processing of all provider credentialing activities in accordance with client, regulatory, and Credentialing Policy and Procedures
• Assembled and prepared credentialing information for appropriate committees
• Review provider files for appropriate documentation required for the credentialing process Prepare files for audits and maintain electronic data input activities
• Collect applications, contracts, current physician licenses, DEA licenses, malpractice insurance, board certifications and other pertinent forms Perform credential verification and correct any inaccurate information
• Manage and maintain daily workflow of the Data Entry Department
• Trained and Audit Overseas Data Entry Production Team
• Ensure production and quality standards are met
• Responsible to track employee performance and measure workflow outcomes
• Responsible for interviewing & training credentialing candidates