Marisela Perez
Salt Lake City,UT
Summary
Expert verification specialist with over 6 years experience in credentialing and healthcare operations for one of the top outsourced Credential Verification Organizations in the US. Experienced with HIPAA, NCQA, FCRA, and URAC. Trained existing staff and new hires on tools and process while emphasizing the importance of maintaining quality standards. Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Credentialing Specialist
Verisys - CheckMedic
02.2016 - Current
- Assigned to the company's most complex and valuable customer accounts to perform end-to-end cycle credentialing and final quality reviews
- Experience with CAQH in reviewing and obtaining up to date provider information needed for credentialing purposes
- Keep up to date with altering customer business rules by analyzing and collecting missing and/or incorrect data to safeguard high-quality standards
- Frequently answer questions, provide training, and insight regarding various client business rules.
Verification Specialist
Verisys
09.2013 - 02.2016
- Perform 1000s of daily new hire background screening verifications using state boards and federal sites
- Research and organize data to deliver real-time results to customer with over 99% accuracy.
Education
Bachelor of Science - Sociology
University of Utah
Salt Lake City, Utah2013
Skills
- Insurance coverage verification
- Data verification
- Data Entry
- Prior authorization processing
- Background Checks
- Information Protection
- Networking Events
Certification
Property & Casualty Insurance License
NPN 20815849
Languages
Spanish
Native or Bilingual
Timeline
Credentialing Specialist
Verisys - CheckMedic
02.2016 - Current
Verification Specialist
Verisys
09.2013 - 02.2016
Bachelor of Science - Sociology
University of Utah
Property & Casualty Insurance License
NPN 20815849
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