Michelle Stubbs
Miami
Summary
Dynamic Credentialing Manager with extensive experience at HCA, excelling in provider enrollment and compliance oversight. Proven track record in streamlining credentialing processes, enhancing operational efficiency, and fostering cross-functional collaboration. Adept at data analysis and effective communication, ensuring timely onboarding and regulatory adherence for healthcare providers.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Credentialing Manager
HCA
REMOTE
05.2024 - Current
- Manage end-to-end credentialing and enrollment for Providers
- Coordinate enrollment with Medicare, Florida Medicaid, and commercial payers
- Ensure accurate completion and submission of all credentialing applications and documentation
- Maintain credentialing records and documentation in compliance with regulatory standards
- Maintain and oversee CAQH profiles, PECOS enrollment, NPPES registrations, and related provider databases
- Build and maintain a centralized credentialing tracking system to monitor provider enrollment status
- Develop reporting dashboards to provide leadership visibility into credentialing progress and provider activation timelines
- Identify process inefficiencies and implement workflow improvements to reduce enrollment delays
- Track provider onboarding timelines from signed employment agreement through first billable claim
- Collaborate with Talent Acquisition and Operations to align credentialing timelines with provider start dates
- Work closely with the Revenue Cycle team to ensure providers are fully enrolled and eligible to bill payers
- Coordinate group credentialing and payor enrollments for new practice locations
- Manage Tax Identification Number (TIN) additions and payor panel participation
- Support credentialing needs related to organizational growth and new service offerings
Executive Assistant CMO/ Credentialing Manager
Miami Jewish Health
Miami
04.2022 - 02.2024
- Coordinate initial and ongoing credentialing and recredentialing of providers
- Prepare & submit enrollment applications to Medicare, Medicaid, and other payers
- Manage and maintain accurate CAQH profiles, timely attestations and updates
- Verify provider credentials, licenses, certifications, and affiliations
- Manage roster updates and portal submissions to ensure network accuracy
- Track and resolve enrollment-related issues with payers and internal teams
- Facilitate onboarding of new providers and support organizational transitions
- Liaise with billing and operations teams to prevent claim disruptions due to enrollment errors.
Credentialing Specialist
Health Choice Network
Doral
12.2016 - 03.2022
- Worked with delegated credentialing customers to provide complete credentialing packets per contract
- Maintained credentialing data and packets for monthly and bi-annual downloads to hospitals
- Managed credentialing payments to ensure timely processing
- Identified and analyzed physician information for accuracy and compliance
- Tracked delegated credentialing application process to promote compliance and efficiency
- Maintained copies of current state licenses, DEA certificates, malpractice coverage, and other required documents
- Followed up on missing information to complete credentialing process
- Reported potential derogatory issues to leadership and collaborated with practitioners to resolve them
- Provided delegated credentialing facilities with current list of provider privileges on a quarterly basis
- Worked with Senior Re-credentialing and Physician Maintenance Coordinator to provide checklist or date report of completed credentialing
- Read and abided by company's code of conduct, ethics, and policies
- Participated in mandatory training programs
Education
Medical coding and billing - Certificate
D A Dorsey Educational Center
Miami, FL08-2013
High school diploma -
Miami Central Senior High School
Miami, FL07-2006
Skills
- Credentialing management
- Provider enrollment
- Compliance oversight
- CAQH maintenance
- Application processing
- Healthcare regulations
- Data analysis
- Project coordination
- Cross-functional collaboration
- Attention to detail
- Effective communication
Certification
Certified Provider Credentialing Specialist
Languages
English
Timeline
Credentialing Manager
HCA
05.2024 - Current
Executive Assistant CMO/ Credentialing Manager
Miami Jewish Health
04.2022 - 02.2024
Credentialing Specialist
Health Choice Network
12.2016 - 03.2022
Medical coding and billing - Certificate
D A Dorsey Educational Center
High school diploma -
Miami Central Senior High School