NICOLE ROSKIN
Summary
Dynamic Credentialing Specialist recognized for a strong track record at AmeriHealth Caritas, specializing in HIPAA compliance and team collaboration. Successfully led credentialing improvements that boosted provider satisfaction and operational efficiency by over 30%. Core competencies include regulatory compliance, effective communication, and problem-solving, driving impactful results in healthcare settings. Aiming to leverage expertise in credentialing to further enhance operational excellence.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Credentialing Specialist
AmeriHealth Caritas
06.2023 - Current
- I play a crucial role in the credentialing process by collaborating with healthcare providers, ensuring accurate documentation, and maintaining compliance with industry standards
- Effectively managed multiple priorities, conducted audits, and performed primary source verifications like background checks and board certifications
- Additionally, I facilitated provider enrollments with Medicare, Medicaid, and private insurance plans while safeguarding confidential information
- I promote strong problem-solving skills helped resolve credentialing discrepancies, and enhanced processes by streamlining documentation and verification procedures
- Contributed to team collaboration by improving communication, implementing centralized tracking systems, and training new employees
- Led to increased accuracy in database management, reduced errors, and improved provider satisfaction
- Furthermore, played a key role in policy updates, accreditation compliance, and advocating for staff needs, ultimately strengthening the overall efficiency of credentialing operations
Office Manager
Educators Financial Group
Houston, USA
08.2021 - 06.2022
- I played a key role in optimizing office operations, enhancing efficiency, and improving customer satisfaction
- By streamlining document management, implementing organizational strategies, and coordinating vendor contracts, which reduced costs and improved accessibility
- I fostered team collaboration through regular meetings and effective task delegation while also handling recruitment, onboarding, and training for new employees
- Proactive engagement with stakeholders strengthened relationships, and focused on customer service ensured prompt resolution of inquiries
- Additionally, managed office inventory, oversaw facility maintenance, upgraded technology, and leveraged data analytics to drive business improvements
Office Manager
Sunset Hospice
Tomball, USA
11.2020 - 05.2021
- Effectively managed office operations by streamlining document management, optimizing budgets, and enhancing communication between departments
- My strong organizational skills improved financial control, inventory management, and vendor negotiations, resulting in cost savings and efficiency gains
- Played a key role in recruitment, onboarding, and fostering a positive work environment by addressing employee concerns and promoting collaboration
- Additionally, ensured workplace safety, facilitated office relocations, and implemented digital tools to enhance workflow
- Played a keep part with customer service expertise and proactive approach to problem-solving contributed to increased satisfaction and smoother daily operations
Credentialing Coordinator
Prime Healthcare Group
Denville, USA
08.2015 - 06.2016
- Experienced in managing the credentialing process, verifying provider qualifications, and ensuring compliance with federal and state regulations
- Skilled in tracking license expirations, coordinating timely renewals, and implementing efficient data management systems to streamline operations
- Strong communicator with the ability to collaborate with healthcare providers, external agencies, and internal teams
- Adept at training new staff, maintaining confidentiality, and contributing to risk management initiatives to minimize legal complications
- Dedicated to improving workflow efficiency and supporting professional development within medical staff
Education
Some College (No Degree) - Communications
Brookdale Community College
Lincroft, NJSkills
- HIPAA compliance
- Provider enrollment
- Data management
- Credentialing oversight
- Application management
- Document review
- Regulatory compliance
- Database maintenance
- Training and mentoring
- Medical terminology
- Organizational development
- Problem solving
- Communication
- Customer service
- Team collaboration
- Financial management
- Inventory management
- Scheduling
- Risk management
- Background checks
Certification
National Association Medical Staff Services Certification - NAMSS, 04/01/16
Timeline
Credentialing Specialist
AmeriHealth Caritas
06.2023 - Current
Office Manager
Educators Financial Group
08.2021 - 06.2022
Office Manager
Sunset Hospice
11.2020 - 05.2021
Credentialing Coordinator
Prime Healthcare Group
08.2015 - 06.2016
Some College (No Degree) - Communications
Brookdale Community College
Similar Profiles
Debra CaldwellDebra Caldwell
Independent Contractor – Member Services at AmeriHealth Caritas Pennsylvania - Medicaid & Keystone First – AmeriHealth Caritas Pennsylvania Community Health Choices – Keystone First Community Health ChoicesIndependent Contractor – Member Services at AmeriHealth Caritas Pennsylvania - Medicaid & Keystone First – AmeriHealth Caritas Pennsylvania Community Health Choices – Keystone First Community Health Choices
Tiesha ReidTiesha Reid
Personal Care Connector at AmeriHealth Caritas of DelawarePersonal Care Connector at AmeriHealth Caritas of Delaware
DAQUICE PEARSONDAQUICE PEARSON
Provider Enrollment Specialist at AmeriHealth CaritasProvider Enrollment Specialist at AmeriHealth Caritas
Timothy DetmanTimothy Detman
Manager, Business Systems Analysis at AmeriHealth CaritasManager, Business Systems Analysis at AmeriHealth Caritas
Kimberly McKelveyKimberly McKelvey
Credentialing Specialist at Humana Insurance CompanyCredentialing Specialist at Humana Insurance Company