Summary
Overview
Work History
Skills
Additional Information
Certification
Timeline
Generic

Sarah Wilson

Taylorsville,Kentucky

Summary

Driven Credentialing Specialist with a proven track record at Humana Military, adept in HIPAA Compliance and training new employees. Excels in streamlining credentialing processes, enhancing data management, and improving provider enrollment efficiency. Demonstrated exceptional multitasking abilities, leading to significant cost reductions and compliance achievements.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Credentialing Specialist

Humana Military
12.2018 - Current
  • Collaborates with healthcare providers to gather necessary information for accurate credentialing decisions
  • Manages multiple priorities effectively, resulting in on-time completion of credentialing tasks for numerous providers simultaneously.
  • Conducts audits of provider files, ensuring all necessary documents are up-to-date and compliant with regulatory requirements.
  • Conducts primary source verifications such as background checks and board certifications.
  • Safeguards confidential provider information by adhering to strict data privacy regulations and company policies.
  • Receives and evaluates applications to look for missing and inaccurate information.
  • Demonstrates excellent problem-solving skills when confronted with complex issues or discrepancies during credentialing process.
  • Assists in training new employees on proper credentialing procedures, contributing to their rapid integration into team environment.
  • Prepares records for site visits and file audits.
  • Updates and maintains accurate records in credentialing databases, ensuring timely renewals and verifications.
  • Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.

Credentialing Coordinator

Aperture Credentialing
07.2016 - 12.2018
  • Assisted with special projects as needed, demonstrating adaptability and commitment to the success of the organization.
  • Fostered a positive work environment through active participation in team meetings, collaborating on strategies to improve departmental performance.
  • Streamlined the credentialing process by implementing an efficient tracking system for medical staff applications.
  • Improved turnaround times for processing credentials by diligently reviewing and verifying provider eligibility.

Skills

  • HIPAA Compliance
  • Provider enrollment
  • Background Checks
  • Data Management
  • Document Review
  • eVIPs expertise
  • Microsoft Office
  • Remote Conferencing and Communication
  • Complaint Handling
  • Training and mentoring
  • Cost Reductions
  • Multitasking Abilities

Additional Information

Awarded the Humana Military Star Award three times for excellent service.

Certification

  • Credentials Verification Organizations Accreditation Training (URAC) - 2018 - Present

Timeline

Credentialing Specialist

Humana Military
12.2018 - Current

Credentialing Coordinator

Aperture Credentialing
07.2016 - 12.2018

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Sarah Wilson