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
2023.12 - 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
2019.09 - 2023.12
- 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
2013.08 - 2019.08
- 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
2023.12 - Current
Credentialing Specialist
Inova Health System
2019.09 - 2023.12
Guest Service Associate
Target Super Store
2013.08 - 2019.08
Bachelor of Science - Business Administration And Management
George Mason University, School of Business
Associate of Science - Accounting And Business Management
Northern Virginia Community College
Similar Profiles
Aminata BanguraAminata Bangura
Patient Safety Associate at Inova Health SystemPatient Safety Associate at Inova Health System
Harpreet KaurHarpreet Kaur
Project Analyst Lead at Inova Health SystemProject Analyst Lead at Inova Health System
Monica P. PohlMonica P. Pohl
Financial Specialist II/ Float FS II at Inova Health SystemFinancial Specialist II/ Float FS II at Inova Health System