María E Colón
Orlando,FL
Summary
Accomplished Credentialing Specialist with over 3 year of experience accomplishing demanding information security related tasks. Maintains strict data accuracy, retention and access expectations according to internal productivity demands. Organized, thorough approach toward handling credentialing procedures and addressing requests-for-access. Tracked and compiled information management needs to ascertain access tiers.
Overview
18
18
years of professional experience
Work History
Credentialing Specialist
24 HOURS MEDICAL STAFFING LLC
DIAMOND BAR, CA
08.2022 - 12.2023
- Credentialed new PD, Travel and Allied candidates for different healthcare roles and facilities as assigned in a timely matter, meeting client's deadline.
- Completed re-credentialing process for returning candidates.
- Maintained great professional communication with Recruiters, Managers,Candidates and clients via email, text and phone at all times.
- Worked hand on hand with recruiters to ensure a smooth process for all candidates.
- Maintained detailed records of candidates and clients data in the credentialing database system.
- Monitored files to ensure completeness and accuracy.
- Ensured timely completion of credentialing processes by providing guidance to candidates on required documentation.
- Reviewed all files documentations for compliance with quality standards, accreditation requirements, and all other relevant policies.
- Prepared and provided information to internal and external clients as required.
- Conducted license, employment, and education verifications through Private Eye, Universal.
- Conducted background checks on potential providers utilizing various resources including state licensing boards, OIG and GSA Exclusion List, NPDB.
- Validated primary source documents such as licenses, diplomas, certifications and other related credentials.
- Provided support in responding to inquiries from clients regarding credentialing information.
- Followed medical staff policies, regulations, and bylaws.
- Kept track of health screening requests and invoices with Concentra, Wellness Mart and Lab Corp.
- Prepared all clients requirements on packets or through their VMS.
- Assisted Candidates filling out or completing documents by phone, email, or text.
- Participated actively in special projects or initiatives pertaining to improvement of operational efficiency within the department.
- Assigned and followed up on required exams using Relias and Nexus.
- Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
Call Center Representative
MG-CALL CENTER REPRESENTATIVE (POD), ADVENTHEALTH PEDIATRICS
LAKE MARY, FL
11.2021 - 08.2022
- Handled inbound and outbound English and Spanish calls patients/parents and provided assistance with appointments, billing questions, and other customer service related issues.
- Scheduled appointments for thirteen offices, following each office specific rules and requirements.
- Assisted parents with new patients and newborns registrations and basic orientation.
- Used proper systems to verify eligibility.
- Created patient case for refill, physical and immunization requests.
- Delivered detailed messages and patients request to the proper department or provider.
- Adhered strictly to all applicable laws and regulations pertaining to customer privacy rights.
- Developed effective working relationships with team members across multiple departments.
- Attended regular training sessions on updates and changes within the industry or organization.
- Resolved patients complaints in a timely manner to ensure customer satisfaction.
- Maintained records of patients interactions, transactions, comments, and complaints.
- Utilized knowledge base to answer inquiries from patients quickly and effectively.
- Performed follow-up calls as necessary to ensure satisfactory resolution of patients inquiries.
- Maintained high levels of professionalism while interacting with patients via phone or email while using Athena, EPIC, Five9.
- Updated customer accounts, addresses and contact information within call management databases.
- Engaged actively with callers, confirming or clarifying information.
- Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
Reservations / Bilingual Central Baggage Assistance
ESP RESERVATIONS / BILINGUAL CENTRAL BAGGAGE ASSISTANCE (REMOTE), JETBLUE
ORLANDO, FL
10.2015 - 02.2022
- Answered incoming calls from customers and travel agents for reservations in a timely manner.
- Maintained knowledge of airline routes and fares as well as current promotional offers.
- Ensured accuracy of all reservation data entered into the computer system.
- Managed special requests such as wheelchair assistance or meal preferences while making reservations.
- Greeted callers in a professional manner; identified their needs; provided quality service throughout the entire call process.
- Worked closely with other departments and airports within the organization to ensure smooth process on recuperation of delayed bags.
- Handled customer complaints promptly by providing appropriate solutions or alternatives within the time limits set by management.
- Participated in team meetings and brainstorming sessions to generate ideas for improving overall efficiency and productivity.
- Delivered exceptional service to every customer through active engagement, effective listening and well-developed interpersonal skills.
- Assisting customers creating detailed baggage reports and explaining bag research process
- Assisted customers with claims resolutions by offering credits or new luggage option.
- Followed up with customers with updates on their reports and communicate via email.
- Averaged upwards of 250 same day files and 300 stations files daily to research and recover bags.
- Conducted in-depth research for positive bag matches and recovery.
- Assisted customers, both in English and Spanish, in creating, editing, refunding, and maintaining reservations.
- Communicated in professional manner assuring a clear and concise message, delivered with confidence.
Administrative Official
AEELA
HATO REY, PR
01.2009 - 01.2015
- Monitored Associate Service Agents' performance and productivity on a daily, weekly and monthly basis
- Monitored associates accounts and updated records accordingly.
- Initiated operations improvements to raise overall call center productivity.
- Performed quality control reviews of transactions to ensure accuracy and completeness.
- Resolved associates inquiries promptly by providing accurate information in a timely manner.
- Completed monthly reports detailing account activity, transaction volumes and any discrepancies identified during audits.
- Prepared monthly reports and day to day written communications for senior management.
- Analyzed customer data to identify areas of risk and recommended appropriate actions to mitigate those risks.
- Maintained an up-to-date knowledge of all applicable laws, regulations, policies and procedures related to banking operations.
- Participated in training sessions designed to keep personnel abreast of changes in the industry.
- Conducted performance evaluations, documented outcomes and made recommendations.
- Coordinated preparation of external audit materials and external financial reporting.
- Scheduled and coordinated meetings, appointments, orientations and travel arrangements for marketing officials and Marketing Department Director.
- Processed all promotional items requests for marketing officials and other departments.
- Kept the inventory for the Marketing Department promotional items warehouse.
- Assisted the Marketing officials' activities/presentations as needed.
- Assisted with new products information for associates.
- Received and processed new applications for retirees to become associates and applications for higher/additional deductions requests.
- Prepared report with new associates/additional deductions for the Collections Department.
- Assisted with the Collections Department Supervisor to comply with the collections processed.
- Assisted associates with payment options.
- Reviewed collections processed and forward them to the Legal Department or to the Investigators.
Credentialing Specialist (REMOTE)
Florida Best Home Health
Miami, FL
06.2009 - 01.2011
- Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
- Validated primary source documents such as licenses, diplomas, certifications and other related credentials.
- Maintained detailed records of provider data in the credentialing database system.
- Performed initial review for new providers to determine eligibility for enrollment into the network.
- Participated in periodic audits of credentialing files to maintain compliance with applicable regulations and policies.
- Conducted background checks on potential providers utilizing various resources including state licensing boards, OIG and GSA Exclusion List, NPDB.
- Processed re-credentialing applications for existing providers according to contractual requirements.
- Provided support in responding to inquiries from external parties regarding credentialing information.
- Researched discrepancies between submitted provider data and verified sources when necessary.
- Attended meetings and seminars related to healthcare industry regulations and trends.
- Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
- Performed primary source verifications such as criminal histories, licenses and board certifications.
Supervisor
XACTS TELESOLUTIONS (REMOTE)
UNITY, ME
08.2005 - 05.2008
- Directed and supervised team of 18 employees in daily operations.
- Developed and implemented operational policies and procedures to ensure efficiency and accuracy of workflows.
- Maintained accurate records of employee performance, attendance, leave requests, and disciplinary actions.
- Resolved customer complaints in a timely manner while ensuring customer satisfaction.
- Conducted weekly meetings with team members to discuss upcoming tasks and project deadlines.
- Recruited, hired, trained, mentored, coached, evaluated, and terminated staff as necessary.
- Monitored and analyzed call volume and average call time, monitoring CSA's performance and productivity, and took actions needed to address areas in need of improvement.
- Evaluated employee performance through periodic reviews and documented results accordingly.
- Provided guidance and direction to subordinates regarding job duties and responsibilities.
- Collaborated with other departments to coordinate workflow processes between teams.
- Complied with company policies, objectives and communication goals.
- Developed training presentation and trained new hires and provided ongoing training to address staff needs.
- Established and enforced clear goals to keep employees working collaboratively.
- Maintained operating schedules to provide effective coverage for key areas and achieve objectives.
- Interviewed applicants, recommended individuals for hiring and evaluated staff performance.
- Responded to employee concerns or complaints by coordinating with human resources team to solve issues.
- Coached staff members to develop long-term career goals.
- Maintained positive working relationship with fellow staff and management.
- Monitored operations and reviewed records and metrics to understand company performance.
- Worked closely with human resources to support employee management and organizational planning.
- Contributed to the development of protocols and procedures for the establishment of the Bilingual Customer Service Department.
- Recommend changes to existing policies and procedures when necessary to achieve improvement in business goals.
- Trained and coach Team Leaders to move forward in customer service supervision roles.
- Evaluated reviews and submitted recommendations for salary increase and promotions or corrective actions.
Education
BACHELOR OF SCIENCE - HEALTH SCIENCE, ADMINISTRATION
University of Puerto Rico, Medical Science Campus
12.2010
ASSOCIATE DEGREE - RADIOLOGY TECHNOLOGIST
University of Puerto Rico, Medical Science Campus
12.2007
Skills
- Policies Implementation
- Procedure Compliance
- New Hire Onboarding
- Pre-Employment Screening
- Time Tracking and Payroll Administration
- Provider Relations
- Regulatory Compliance
- Excellent Time Management
- Medical Terminology knowledgeable
- Fully Bilingual
- Detailed oriented
- Community Health Center Credentialing
- Management Collaboration
- Employee Onboarding
- Facility Credentialing
- License Verifications
- Microsoft Office
- Data Acquisition
- Recruitment and Hiring
- Training and Mentoring
- Employee and Applicant Assessment
- In-Person and Telephone Interviewing
References
References available upon request.
Timeline
Credentialing Specialist
24 HOURS MEDICAL STAFFING LLC
08.2022 - 12.2023
Call Center Representative
MG-CALL CENTER REPRESENTATIVE (POD), ADVENTHEALTH PEDIATRICS
11.2021 - 08.2022
Reservations / Bilingual Central Baggage Assistance
ESP RESERVATIONS / BILINGUAL CENTRAL BAGGAGE ASSISTANCE (REMOTE), JETBLUE
10.2015 - 02.2022
Credentialing Specialist (REMOTE)
Florida Best Home Health
06.2009 - 01.2011
Administrative Official
AEELA
01.2009 - 01.2015
Supervisor
XACTS TELESOLUTIONS (REMOTE)
08.2005 - 05.2008
BACHELOR OF SCIENCE - HEALTH SCIENCE, ADMINISTRATION
University of Puerto Rico, Medical Science Campus
ASSOCIATE DEGREE - RADIOLOGY TECHNOLOGIST
University of Puerto Rico, Medical Science Campus
Similar Profiles
Janus YambaoJanus Yambao
Independent Contractor - Recruitment Specialist at 24 Hour Medical Staffing, LLCIndependent Contractor - Recruitment Specialist at 24 Hour Medical Staffing, LLC
Nicolas E Villanueva MendozaNicolas E Villanueva Mendoza
Medical Laboratory Technician at Vet Clinic 24 HoursMedical Laboratory Technician at Vet Clinic 24 Hours
Lily PelletierLily Pelletier
Certified Nurse Aid at Complete Home Healthcare Hours Per Week: 20-24Certified Nurse Aid at Complete Home Healthcare Hours Per Week: 20-24