PEYTON RUNIONS
Bealeton,VA
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
11
11
years of professional experience
Work History
Credentialing Coordinator
Inova Health System
12.2023 - Current
- Pulls monthly data reports from database to perform audit accuracy of information
- Works with medical staff office leaders and directors to ensure a completed credentialing process
- Leads process improvement meetings and collaborates with team to encourage changes in policy/documents
- Performs audits on credentialing teams for accuracy of physician/APP database files
- Manages monthly tracking list documentation
- Analyzes delineation of privileges (DOPs) for physician/APP privilege criteria
- Works with risk management to obtain claims history documentation for medical malpractice insurance
- Facilitates training and policy manual updates for team members
- Works additional hours to assist the team with transition of credentialing files
- Works with network payer department to obtain Medicare/Medicaid information
- Processes critical files in a timely manner to meet committee dates
- Coordinates with other specialists regarding sensitive health information and red/yellow flags
- Works in compliance with hospital policies and medical staff bylaws.
Credentialing Specialist
Inova Health System
09.2019 - 12.2023
- Voluntarily cross-trained to work to support multiple activities and departments to ensure team success
- Utilized programs for complete and accurate background investigations
- Managed high volumes of assigned files with highest productivity and accuracy
- Assisted the team and supervisors with additional tasks
- Processed credentialing applications efficiently in a timely manner
- Handled challenging situations to ensure provider experience
- Offered high level of customer service to providers needing assistance
- Investigated red/yellow flag concerns with governing boards and committees
- Obtains verification documents needed for processing
- Utilizes identity proofing practices to authorize privileged credentials
- Facilitate peer reference interviews as needed.
Guest Service Associate
Target Super Store
08.2013 - 08.2019
- Trained as cashier
- Managed guest services
- Organized work schedules and breaks for employees
- Communicated and worked with customers to fulfill needs or solved problems effectively
- Managed tasks in multiple departments.
Education
Bachelor of Science - Business Administration And Management
George Mason University, School of Business
Fairfax, Virginia05.2019
Associate of Science - Accounting And Business Management
Northern Virginia Community College
Manassas, Virginia05.2016
Skills
- Proficiency in Microsoft Suite
- Organizational management
- Professional writing and communication
- Proposal writing and management
- Business statistics
- Data analysis
- Reporting
- Data entry
- Investigation
- Proficiency in Morrissey (MSOW) and Axuall
- Web BI for healthcare
- PreCheck and Certiphi
- Office of Inspector General (OIG)
- System for Award Management (SAM)
- Maryland State Sanctions
- Medicare/Medicaid Opt Out
- Preclusion Search
- Social Security Death Master
- State License and DEA Registration
- Identity Proofing
- Malpractice Insurance Claims Report
- Effective written and verbal communication
- Data entry proficiency
- Re-credentialing processes
- Practitioner application monitoring
- Application management
- Credentialing oversight
- Teamwork and Collaboration
- Time Management
- Attention to Detail
- Problem-solving abilities
- Multitasking Abilities
- Excellent Communication
- Critical Thinking
- Organizational Skills
- Team Collaboration
- Effective Communication
- Adaptability and Flexibility
- Decision-Making
- Written Communication
- Process Implementation
References
Available upon Request
Timeline
Credentialing Coordinator
Inova Health System
12.2023 - Current
Credentialing Specialist
Inova Health System
09.2019 - 12.2023
Guest Service Associate
Target Super Store
08.2013 - 08.2019
Bachelor of Science - Business Administration And Management
George Mason University, School of Business
Associate of Science - Accounting And Business Management
Northern Virginia Community College
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