Paula Elstrom
Prior Lake
Summary
Credentialing Specialist Summary
Personable and detail-focused professional with a strong aptitude for managing complex administrative tasks and ensuring compliance with regulatory requirements. Proficient in data entry and maintaining accurate records.
Information Technology
In-depth knowledge and skills in various IT domains. Courses cover areas like cybersecurity, data analytics, cloud computing, network management, and software development. Graduates are prepared for leadership roles, and are capable of aligning technology strategies with business goals.
Graphic Design
Courses geared toward graphic design included learning the foundation in design principles, typography, color theory, and layout. I developed skills in industry-standard software, like Adobe Creative Suite (Photoshop, Illustrator, InDesign), for creating visual content.
Overview
8
8
years of professional experience
Work History
Provider Enrollment
Zotec Partners
11.2024 - 07.2025
- Completed payer applications.
- Reviewed provider enrollment applications for accuracy and completeness.
- Resolved complex issues related to provider enrollment, including discrepancies between submitted data and existing records.
- Used CredentialStream daily.
- Collect, review, and support documents such as license, malpractice insurance, and provider agreements for submission to payers.
CREDENTIALING SPECIALIST (Contract position)
PM Pediatrics (Robert Half)
11.2023 - 05.2024
- Managed Medallion credentialing processes.
- Conducted primary source verification.
- Monitored and managed state and compact license renewals.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Enrolled providers, as well as Medicaid, Medicare, and private insurance plans.
ACCOUNT MANAGER (Provider Enrollments)
Physician Practice Specialists
12.2021 - 12.2023
- Established long-term customer relationships to enhance client loyalty and satisfaction.
- Established clear communication channels between clients and internal teams.
- Facilitated client onboarding processes, ensuring smooth transitions for new accounts.
- Renewed existing accounts by building relationships with clients.
- Onboarded new team members to integrate into organization.
SENIOR CREDENTIALING SPECIALIST (Lay-off)
Sanvello Behavioral Health
02.2021 - 05.2021
- Developed job aids for payer enrollment processes.
- Manage the end-to-end credentialing process, including application review and verification.
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Conducted primary source verifications, such as background checks and board certifications.
- Processed applications for new providers using electronic credentialing systems.
- Verified provider credentials to ensure compliance with industry regulations.
- Maintained detailed records of provider credentials and licensing information.
- Processed re-credentialing applications for existing providers according to contractual requirements.
- Completed enrollments into Medicaid, Medicare and private insurance plans.
- Set up NPI numbers for providers and facilities and updated current profile information.
CREDENTIALING COORDINATOR
Optum/UHG
04.2019 - 04.2020
- Coordinated provider credentialing processes for healthcare professionals and facilities.
- Reviewed applications for accuracy and completeness before submission.
- Maintained detailed records in credentialing databases and tracking systems.
- I stayed up to date with documentation expiration dates, communicating with the correct personnel to submit files prior to expiration.
- Tracked expiration dates on documents, and communicated with appropriate staff to avoid late filing.
CREDENTIALING SPECIALIST
HealthEZ
03.2017 - 02.2019
- Processed documents and status change requests.
- Ensured timely updates to credentialing databases and records.
- Conducting follow-up assessments regarding enrollment inquiries.
- Assisted in training new staff on credentialing procedures and policies.
- Performed primary source verifications such as criminal histories, licenses and board certifications.
- Processed re-credentialing applications for existing providers according to contractual requirements.
Education
Master of Science - Information Technology
Purdue University
West Lafayette, IN10-2024
Bachelor of Science - Social Work
University of St.Thomas
Saint Paul, MN05-2000
Skills
- Provider relations
- Collaboration with other healthcare providers
- Program enrollment
- Time management
- Provider enrollment
Affiliations
- University of St. Thomas Cross Country Running, Track and Field - All American, All Conference, Captain,
- UST Cross Country Running Team 2nd Place at Nationals.
Timeline
Provider Enrollment
Zotec Partners
11.2024 - 07.2025
CREDENTIALING SPECIALIST (Contract position)
PM Pediatrics (Robert Half)
11.2023 - 05.2024
ACCOUNT MANAGER (Provider Enrollments)
Physician Practice Specialists
12.2021 - 12.2023
SENIOR CREDENTIALING SPECIALIST (Lay-off)
Sanvello Behavioral Health
02.2021 - 05.2021
CREDENTIALING COORDINATOR
Optum/UHG
04.2019 - 04.2020
CREDENTIALING SPECIALIST
HealthEZ
03.2017 - 02.2019
Master of Science - Information Technology
Purdue University
Bachelor of Science - Social Work
University of St.Thomas
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