Summary
Overview
Work History
Skills
Timeline
Generic

Robin House

Hewitt,TX

Summary

Accomplished credentialing specialist with several years of experience accomplishing demanding information security related tasks. Maintains strict data accuracy, retention and access expectations according to internal productivity demands. Organized, thorough approach toward handling credentialing procedures and addressing requests-for-access. Tracked and compiled information management needs to ascertain access tiers.

Overview

15
15
years of professional experience

Work History

HR Credentialing Assistant

Waco Family YMCA
Waco, TX
04.2024 - Current
  • Monitored regulatory changes affecting the credentialing process and updated policies accordingly.
  • Ensured that all necessary forms were completed accurately and submitted within specified deadlines.
  • Assisted in maintaining departmental databases including inputting new data into system as well as updating existing information.
  • Compiled monthly statistics on time frames for completion of the credentialing process.
  • Prepared correspondence letters confirming successful completion of the credentialing process following review by governing body.
  • Responded to inquiries from providers regarding their credentialing status.
  • Reviewed applications for completeness and accuracy prior to submission to governing bodies.
  • Followed up with providers regarding missing or incomplete documentation as required by state regulations.
  • Managed communication between providers and hospitals and organizations concerning updates or changes in credentials.
  • Conducted background checks on all new applicants.
  • Assisted in the preparation of credentialing applications and related materials for providers.
  • Maintained records of provider's application status, licensure and accreditation information.
  • Coordinated with other departments to obtain additional documentation needed for credentialing process.
  • Created spreadsheets for tracking provider profiles, privileging requests, re-credentialing.
  • Participated in credentialing committees, presenting cases and making recommendations.
  • Maintained up-to-date records of credentialing statuses in database systems.
  • Developed and implemented credentialing policies and procedures to improve workflow.
  • Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
  • Addressed and resolved discrepancies in provider documentation during credentialing.
  • Performed primary source verifications such as criminal histories, licenses and board certifications.
  • Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
  • Conducted thorough background checks and verified educational and professional qualifications.
  • Coordinated with healthcare professionals to collect necessary documentation for credentialing.
  • Managed end-to-end provider credentialing process, ensuring compliance with industry standards.
  • Set up NPI numbers for providers and facilities and updated current profile information.
  • Performed database queries, compiling information according to requests and logging logistics changes.
  • Coordinated new employee onboarding with orientation scheduling and preparation.

Administrative Assistant

Bluebonnet Health Services
Waco, TX
07.2023 - 04.2024
  • Ensured efficient operation of office equipment such as printers, copiers and fax machines.
  • Organized and maintained filing systems for physical and electronic documents, ensuring accuracy and confidentiality of records.
  • Entered data into spreadsheets using Microsoft Excel or other similar programs.
  • Conducted research on various topics as requested by management.
  • Answered questions from customers regarding products and services offered by the company.
  • Greeted visitors in a professional manner, responding to inquiries and directing them to appropriate personnel.
  • Managed incoming calls while providing information or transferring callers to appropriate personnel.
  • Composed letters, memos, reports, emails, presentations and other written correspondence as required by management staff.
  • Developed and maintained filing systems for confidential documents and records.
  • Managed database systems containing customer contact information.
  • Handled confidential documents in an organized fashion according to established protocol.

Administrative Assistant

Ascension Providence Hospital
Waco, TX
05.2021 - 07.2023
  • Ensured that all necessary forms were completed accurately and submitted within specified deadlines.
  • Created spreadsheets for tracking provider profiles, privileging requests, re-credentialing.
  • Provided assistance in preparing reports related to provider credentials and compliance standards.
  • Followed up with providers regarding missing or incomplete documentation as required by state regulations.
  • Reviewed applications for completeness and accuracy prior to submission to governing bodies.
  • Assisted in the preparation of credentialing applications and related materials for providers.
  • Responded to inquiries from providers regarding their credentialing status.
  • Maintained records of provider's application status, licensure and accreditation information.
  • Coordinated with other departments to obtain additional documentation needed for credentialing process.
  • Prepared correspondence letters confirming successful completion of the credentialing process following review by governing body.
  • Monitored regulatory changes affecting the credentialing process and updated policies accordingly.
  • Assisted in maintaining departmental databases including inputting new data into system as well as updating existing information.
  • Managed communication between providers and hospitals and organizations concerning updates or changes in credentials.
  • Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
  • Conducted thorough background checks and verified educational and professional qualifications.
  • Performed primary source verifications such as criminal histories, licenses and board certifications.
  • Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
  • Checked applications for missing information and organized all paperwork.
  • Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
  • Processed documents and status-change requests, conducting followup assessment regarding enrollment inquiries.
  • Provided guidance and support to new providers throughout the credentialing process.
  • Participated in credentialing committees, presenting cases and making recommendations.
  • Ensured strict confidentiality of provider information in accordance with HIPAA regulations.
  • Maintained up-to-date records of credentialing statuses in database systems.
  • Coordinated with healthcare professionals to collect necessary documentation for credentialing.
  • Coordinated training schedules and filed crucial administrative paperwork.
  • Prepared and set up new employee orientations.
  • Coordinated new employee onboarding with orientation scheduling and preparation.

Credentialing Assistant

Ascension Medical Group
Waco, TX
04.2016 - 05.2021
  • Ensured that all necessary forms were completed accurately and submitted within specified deadlines.
  • Created spreadsheets for tracking provider profiles, privileging requests, re-credentialing.
  • Provided assistance in preparing reports related to provider credentials and compliance standards.
  • Followed up with providers regarding missing or incomplete documentation as required by state regulations.
  • Reviewed applications for completeness and accuracy prior to submission to governing bodies.
  • Acted as liaison between healthcare facilities, insurance companies, and government agencies when necessary.
  • Assisted in the preparation of credentialing applications and related materials for providers.
  • Responded to inquiries from providers regarding their credentialing status.
  • Compiled monthly statistics on time frames for completion of the credentialing process.
  • Performed periodic audits to ensure accuracy of credentialing data and documents.
  • Maintained records of provider's application status, licensure and accreditation information.
  • Coordinated with other departments to obtain additional documentation needed for credentialing process.
  • Prepared correspondence letters confirming successful completion of the credentialing process following review by governing body.
  • Monitored regulatory changes affecting the credentialing process and updated policies accordingly.
  • Assisted in maintaining departmental databases including inputting new data into system as well as updating existing information.
  • Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
  • Performed primary source verifications such as criminal histories, licenses and board certifications.
  • Responded to verification inquiries from other healthcare organizations and insurance companies.
  • Prepared and submitted detailed reports on credentialing progress to management.
  • Liaised with insurance companies to complete provider enrollment and ensure billing capabilities.
  • Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
  • Checked applications for missing information and organized all paperwork.
  • Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
  • Set up NPI numbers for providers and facilities and updated current profile information.
  • Processed documents and status-change requests, conducting followup assessment regarding enrollment inquiries.
  • Performed database queries, compiling information according to requests and logging logistics changes.
  • Ensured strict confidentiality of provider information in accordance with HIPAA regulations.
  • Maintained up-to-date records of credentialing statuses in database systems.
  • Coordinated with healthcare professionals to collect necessary documentation for credentialing.
  • Addressed and resolved discrepancies in provider documentation during credentialing.
  • Completed enrollments into Medicaid, Medicare and private insurance plans.
  • Organized records to prepare for site visits by representatives and associated audits.
  • Verified previous employers and other references to determine applicants' employment acceptability.

Customer Service Representative

Lakeshore Family Medicine
Waco, TX
05.2011 - 04.2016
  • Performed administrative tasks such as filing paperwork, updating databases and generating reports.
  • Verified patient demographic information at time of check-in and check-out.
  • Regularly reviewed office supply inventory levels and placed orders when necessary.
  • Assisted with scheduling appointments, verifying insurance coverage, collecting co-payments, and updating patient information in the electronic medical records system.
  • Answered incoming calls promptly, efficiently processed callers' inquiries, and transferred calls to appropriate personnel when necessary.
  • Ensured all patient paperwork was complete and up to date before submitting it to the billing department for processing claims.
  • Processed payments for services rendered using cash register or point-of-sale system.
  • Greeted patients and visitors in a friendly and professional manner.
  • Trained new staff members on front desk operations and processes.
  • Reconciled daily payments received against charges billed on each account.
  • Informed providers of any changes in patient status or medical history updates during visits.
  • Assisted with administrative tasks such as filing, faxing, copying documents.
  • Prepared charts for new patients prior to their appointment.
  • Performed data entry accurately into the practice's EMR system as needed.
  • Responded to emails from patients inquiring about appointments or other matters related to their care.
  • Resolved customer service issues in a timely manner while maintaining professionalism.
  • Ensured compliance with HIPAA regulations regarding confidentiality of patient information.
  • Provided excellent customer service through courteous interactions with patients and families.
  • Scanned documents into the practice's EMR system as needed.
  • Coordinated referrals between primary care providers and specialists.
  • Monitored waiting room activity ensuring that all patients were attended to in a timely fashion.
  • Followed HIPAA guidelines when handling confidential patient information.

Accounting Clerk

The Freeman Center
Waco, TX
06.2010 - 05.2011
  • Resolved customer inquiries regarding bills and payments.
  • Analyzed variances between budgeted expenses and actual expenses.
  • Provided support to the Accounts Payable department as needed.
  • Prepared bank deposits by compiling data from cashiers.
  • Assisted with the preparation of month-end close activities including journal entries, reconciliations, accruals.
  • Maintained up-to-date accounts receivable records and coordinated monthly billing activities.
  • Reviewed banking activity regularly to identify any irregularities or unauthorized transactions.
  • Reviewed vendor invoices for accuracy prior to payment processing.
  • Reviewed accounts payable ledgers for accuracy and completeness prior to payment processing.
  • Verified accuracy of vendor invoices against purchase orders before entering into system for payment processing.
  • Processed invoices, payments, and statements in a timely manner.
  • Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
  • Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
  • Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
  • Verified the accuracy of claim data prior to submission to insurance carriers.
  • Created and processed claims to third-party payers using specific coding guidelines.
  • Processed credit card payments from patients in accordance with office policy.
  • Adhered to HIPAA regulations when handling confidential patient information.

Intake and Referral Specialist

Council on Alcohol and Drug Abuse
Waco, TX
05.2009 - 06.2010
  • Resolved escalated patient complaints relating to denied or delayed referrals promptly.
  • Participated in staff meetings and provided feedback on ways to improve procedures related to referral processing.
  • Researched and responded to inquiries from providers regarding pending or denied referrals in a timely manner.
  • Collaborated with team members to ensure the accuracy of referral data entered into the system.
  • Maintained accurate records of client intakes in electronic database system.
  • Communicated effectively with supervisors regarding current caseloads and resource availability.
  • Coordinated transportation arrangements for clients as needed.
  • Assisted in determining appropriate referrals for clients to other community agencies or programs.
  • Provided education about available services, benefits, rights, responsibilities, risks and benefits of treatment options.
  • Coordinated the intake process for new clients, including scheduling initial assessments and providing necessary paperwork.
  • Adhered to confidentiality guidelines when handling sensitive information about clients.
  • Conducted comprehensive interviews with potential clients to determine eligibility for services.
  • Scheduled appointments and coordinated logistics for initial assessments and follow-up meetings.

Skills

  • Application processing
  • Credential verification
  • Document Review
  • Background Checks
  • Policy Adherence
  • Report Generation
  • Community health center credentialing
  • License verifications
  • HIPAA Compliance
  • Database Maintenance

Timeline

HR Credentialing Assistant

Waco Family YMCA
04.2024 - Current

Administrative Assistant

Bluebonnet Health Services
07.2023 - 04.2024

Administrative Assistant

Ascension Providence Hospital
05.2021 - 07.2023

Credentialing Assistant

Ascension Medical Group
04.2016 - 05.2021

Customer Service Representative

Lakeshore Family Medicine
05.2011 - 04.2016

Accounting Clerk

The Freeman Center
06.2010 - 05.2011

Intake and Referral Specialist

Council on Alcohol and Drug Abuse
05.2009 - 06.2010

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Robin House