MALISSA POPE

Conducted evaluations to identify issues and ensure accuracy.

Ensure accurate processing of initial and renewal Ensured accuracy and compliance of credentialing information..

Provided comprehensive care to patients at Tampa Family Health Centers, Inc.

Oversaw adherence to state requirements for proper training, licensing, and certification of TFHC personnel.

Analyzed and implemented compliance strategies aligned with federal regulations.

Executed core responsibilities and ensured seamless operational workflows.

Facilitates effective interaction between hospital personnel and administrative departments.

Collaborated with providers to gather and assess healthcare plan details.

credentialing data

Administered the documentation process, monitoring crucial provider details and expiry timelines.

certifications and licenses, ensuring the providers update their

certification and/or licensure timely

Managed timely preparation of credentialing files for Board review.

Coordinated processing of provider privileges at TFHC.

Managed re-credentialing for applicants.

providers that will include reviewing resumes, conducting

background checks, contacting licensing boards, reviewing license

applications, obtaining educational information, and securing

Established and maintained comprehensive reference database.

Organizes and maintains electronic information for providers.

credentialing database system

Ensured compliance with evolving medical credentialing requirements.

Keep abreast of current medical legislation and standards.

Executed additional tasks delegated by supervisor.

• Managed credentialing efforts for over 150 physicians, ensuring compliance with state and federal standards
• Completed credentialing applications and contracts with health plans
• Worked cross-functionally with departments to meet business goals and handle escalated issues
• Developed recommendations for corrective action and tracked performance trends

• Monitored documentation expiration dates and ensured timely file submissions
• Used CAQH to maintain databases of physician records and credentialing documents
• Assisted with managed care auditing processes and internal file audits

• Conducted primary source verification of credentials in compliance with regulatory standards
• Prepared credential files for management and committee reviews
• Documented all communications and actions during the credentialing process

• Completed enrollments into Medicaid, Medicare, and private insurance plans
• Monitored disciplinary actions and corresponded with licensing boards, hospitals, and medical groups to resolve issues
• Assisted in the preparation of file reports and binders for monthly Credentialing Committee meetings