Rebecca Horton
Bluefield,VA
Summary
Experienced Credentialing Analyst adept at primary source verifications. Excellent relationship-building, and communication skills. Fantastic critical thinker and efficiently organize vast amounts of data. Great at performing internal audits, conducting investigative reporting and transcribing information. Fantastic at problem-solving and verifying information. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
7
7
years of professional experience
Work History
Associate Consultant-IT Support
AMN Healthcare
09.2023 - 01.2024
- Enhanced client satisfaction by providing tailored solutions and recommendations for their business needs.
- Collaborated closely with cross-functional teams to devise effective strategies and action plans for clients'' businesses.
- Developed strong relationships with clients, fostering trust and ensuring long-term partnerships.
- Delivered outstanding service to clients to maintain and extend relationship for future business opportunities.
Credentialing Analyst
AMN Healthcare
04.2021 - 05.2023
- Streamlined the credentialing process by implementing efficient tracking systems and maintaining accurate records.
- Enhanced department productivity with proper organization and timely completion of tasks.
- Ensured compliance with state regulations and accreditation standards by conducting thorough audits of credentials files.
- Collaborated with medical staff to gather necessary documentation for timely processing of provider applications.
- Facilitated strong relationships between providers and facilities through effective communication and coordination during the credentialing process.
- Completed comprehensive background checks, ensuring all candidates met company standards for quality care provision.
- Reduced processing time significantly by identifying areas for improvement in workflow processes.
- Maintained up-to-date knowledge of industry trends, best practices, and regulatory changes to ensure optimal efficiency within the credentialing department.
- Implemented regular training sessions to keep team members informed about relevant laws, policies, and procedures related to healthcare credentialing.
- Successfully resolved complex issues regarding licensing discrepancies or other concerns involving provider qualifications.
- Expedited the onboarding process for new providers by accurately verifying their education, training, experience, certifications, and licenses within strict timelines.
- Developed user-friendly guides for healthcare professionals seeking credentialing assistance, streamlining their experience while ensuring compliance with internal protocols and external regulations.
- Assisted in maintaining an updated database of credentialed providers, allowing for quick access to essential information when needed by senior management or other departments within the organization.
- Managed strict deadlines effectively, prioritizing tasks and efficiently allocating resources to ensure optimal productivity.
- Troubleshot issues with electronic applications, quickly identifying problems and implementing solutions to maintain workflow efficiency.
- Supported quality assurance initiatives by conducting ongoing reviews of internal procedures and making recommendations for improvements as needed.
- Conducted primary source verifications and board certifications.
- Prepared records for site visits and file audits.
- Maintained up-to-date knowledge of applicable laws and regulations.
- Created and maintained compliant work environment.
- Identified gaps in existing compliance processes and recommended updates.
- Developed and implemented corrective action plans for non-compliance issues.
- Conducted periodic compliance audits and reviews to identify areas of improvement.
- Assisted with development of compliance objectives and strategies.
- Maintained composure in stressful situations, confrontations, interviews and records searches.
- Warned violators of infractions or penalties.
Charge Capture Specialist
Bluefield Regional Medical Center
01.2017 - 07.2020
- Improved charge capture accuracy by meticulously reviewing medical records and identifying missing charges.
- Enhanced revenue cycle management processes through diligent charge entry and reconciliation tasks.
- Collaborated with clinical staff to ensure accurate documentation of services provided for proper billing.
- Reduced claim denials by closely monitoring coding updates and implementing necessary changes in a timely manner.
- Assisted in the development of training materials for new Charge Capture Specialists, streamlining the onboarding process.
- Implemented efficient workflow processes for expedited charge submission, resulting in improved cash flow.
- Conducted regular audits of charge capture practices, identifying areas of improvement and implementing corrective actions as needed.
- Demonstrated exceptional attention to detail when entering patient demographic information, reducing errors that could impact reimbursement rates.
- Proactively identified trends in denied claims, taking action to address root causes and prevent future occurrences.
Education
Bachelor - Criminal Justice
Walden University
Minneapolis, MNCertificate - Medical Transcription
Wytheville Community College
Wytheville, VA05.2018
Skills
- HIPAA Compliance
- Customer Service
- Medical Terminology
- Interpersonal Skills
- Conflict Resolution
- Decision Making
- Organizational Skills
- Time Management
- Data Analysis
- Problem Solving
- Critical Thinking
- Training and Development
- Microsoft Office Proficiency
- Multitasking
- Ethical Standards
- Process Improvement
- Quality Assurance
- Database Management
- Attention to Detail
- Adaptability
- Project Management
- Facility Support
- Background Checks
- License Verification
- Risk Assessment
- Investigative Reporting
- SOP Development
- Legal Compliance
- Audit Coordination
- Compliance Monitoring
- Data Verification
- Compliance Training
Timeline
Associate Consultant-IT Support
AMN Healthcare
09.2023 - 01.2024
Credentialing Analyst
AMN Healthcare
04.2021 - 05.2023
Charge Capture Specialist
Bluefield Regional Medical Center
01.2017 - 07.2020
Bachelor - Criminal Justice
Walden University
Certificate - Medical Transcription
Wytheville Community College
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