Summary
Overview
Work History
Education
Skills
References
Timeline
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Patrick Hogan

Credentialing Representative
Enola,PA

Summary

Credentialing Lead Specialist at Highmark Blue Shield with expertise in lead management and process optimization. Proven ability in data analysis and compliance auditing, resulting in improved team performance and customer satisfaction. Successfully mentored teams and resolved complex issues through strategic initiatives. Dedicated to continuous improvement and building strong professional relationships.

Overview

18
18
years of professional experience

Work History

Credentialing Lead Specialist

Highmark Blue Shield
Camp Hill
06.2022 - 06.2025
  • Mentored junior specialists on best practices and strategic project execution methodologies.
  • Participated in weekly meetings with senior leadership team to discuss progress made by Lead Specialists in meeting objectives set out for them.
  • Processed reports based on analysis of lead generation activities performed by Lead Specialists.
  • Assisted in developing best practices for managing leads across multiple departments within the organization.
  • Provided guidance and support to other Lead Specialists in the organization.
  • Resolved escalated customer issues related to lead management activities in a timely manner.
  • Facilitated communication between different departments involved in lead management activities.
  • Analyzed customer feedback, identified trends, and recommended strategies to improve customer satisfaction levels with Lead Specialist services.
  • Ensured compliance with internal policies and procedures regarding lead management activities.
  • Performed regular audits of lead data collected from various sources and ensured its accuracy before being added into database.
  • Identified areas of improvement in lead management processes and developed solutions to address them.
  • Provided feedback and coaching sessions to assist individual specialists in achieving their targets.
  • Maintained positive working relationship with fellow staff and management.
  • Identified needs of customers promptly and efficiently.
  • Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
  • Submitted reports on industry trends, prompting managers to develop business plans.

Credentialing Senior Specialist

Highmark Blue Shield
Camp Hill
03.2017 - 06.2022
  • Mentored junior specialists on best practices and strategic project execution methodologies.
  • Conducted regular reviews of workflows to enhance productivity and streamline operations efficiently.
  • Participated in weekly meetings with senior leadership team to discuss progress made by Lead Specialists in meeting objectives set out for them.
  • Provided guidance and support to other Lead Specialists in the organization.
  • Resolved escalated customer issues related to lead management activities in a timely manner.
  • Ensured compliance with internal policies and procedures regarding lead management activities.
  • Identified areas of improvement in lead management processes and developed solutions to address them.
  • Provided feedback and coaching sessions to assist individual specialists in achieving their targets.
  • Maintained positive working relationship with fellow staff and management.
  • Identified needs of customers promptly and efficiently.
  • Submitted reports on industry trends, prompting managers to develop business plans.

Credentialing Specialist

Highmark Blue Shield
Camp Hill
05.2007 - 03.2017
  • Managed provider credentialing process for high-quality network standards.
  • Reviewed applications for accuracy and compliance with regulations.
  • Coordinated communication with healthcare providers regarding credentialing status.
  • Maintained comprehensive records in credentialing management system.
  • Assisted in auditing credentialing files to ensure completeness and accuracy.
  • Collaborated with internal teams to streamline credentialing workflows.
  • Ensured timely completion of credentialing processes by providing guidance to providers on required documentation.
  • Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
  • Performed primary source verifications such as criminal histories, licenses and board certifications.
  • Processed re-credentialing applications for existing providers according to contractual requirements.
  • Provided support in responding to inquiries from external parties regarding credentialing information.
  • 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.
  • Provided guidance and support to new providers throughout the credentialing process.

Education

High School Diploma -

Cumberland Valley High School
Mechanicsburg, PA
06-1994

Skills

  • Lead management and credentialing
  • Data analysis and reporting
  • Compliance auditing
  • Customer relationship management
  • Credentialing processes
  • Data analysis
  • Workflow optimization
  • Team building
  • Process improvement
  • Effective communication
  • Mentoring junior staff
  • Escalation resolution
  • Problem solving
  • Time management
  • Ethics and integrity
  • Continuous improvement
  • Customer relations
  • Advanced communication
  • Quality assurance
  • Proficient in Excel and Word
  • Interpersonal skills
  • Problem-solving abilities
  • Multitasking capacity
  • Professionalism
  • Goal setting

References

References available upon request.

Timeline

Credentialing Lead Specialist

Highmark Blue Shield
06.2022 - 06.2025

Credentialing Senior Specialist

Highmark Blue Shield
03.2017 - 06.2022

Credentialing Specialist

Highmark Blue Shield
05.2007 - 03.2017

High School Diploma -

Cumberland Valley High School

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Patrick HoganCredentialing Representative