Shanella Carter
Missouri City
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
18
18
years of professional experience
4
4
Certifications
Work History
Credentialing Specialist
Healix Infusion Pharmacy
Sugar Land
10.2025 - Current
- Processed credentialing applications for healthcare providers efficiently.
- Maintained accurate provider databases and updated credentials regularly.
- Coordinated with insurance companies to verify provider information.
- Reviewed and analyzed documentation for compliance with regulations.
- Ensured timely completion of credentialing processes by providing guidance to providers on required documentation.
- Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
- Collaborated with interdisciplinary teams to streamline credentialing workflows.
- Managed timelines for credentialing tasks to ensure timely completion of processes.
- Communicated with providers to resolve credentialing issues effectively.
- Assisted in training new staff on credentialing procedures and policies.
- Processed re-credentialing applications for existing providers according to contractual requirements.
- Prepared correspondence for various departments concerning credentialing updates or requests for additional information.
- Performed primary source verifications such as criminal histories, licenses and board certifications.
- Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
- Participated in periodic audits of credentialing files to maintain compliance with applicable regulations and policies.
- Maintained detailed records of provider data in the credentialing database system.
- Coordinated with internal departments such as medical staff services or risk management to resolve any issues identified during the verification process.
- Completed enrollments into Medicaid, Medicare and private insurance plans.
- Researched discrepancies between submitted provider data and verified sources when necessary.
- Participated actively in special projects or initiatives pertaining to improvement of operational efficiency within the department.
- Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
- Interacted regularly with representatives from health plans and commercial payers regarding credentialing matters.
- Negotiated with credentialing services vendors to secure cost-effective solutions.
- Prepared and submitted detailed reports on credentialing progress to management.
- Ensured strict confidentiality of provider information in accordance with HIPAA regulations.
- Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
- Managed end-to-end provider credentialing process, ensuring compliance with industry standards.
- Developed and implemented credentialing policies and procedures to improve workflow.
- Trained junior credentialing staff on best practices and company-specific procedures.
- Liaised with insurance companies to complete provider enrollment and ensure billing capabilities.
- Participated in credentialing committees, presenting cases and making recommendations.
- Set up NPI numbers for providers and facilities and updated current profile information.
- Served as a resource person for staff members seeking assistance in understanding complex regulatory requirements related to provider enrollment processes.
- Assisted in developing and implementing departmental procedures related to provider enrollment and maintenance activities.
- Hired employees and processed hiring-related paperwork.
- Developed or implemented recruiting strategies to meet current or anticipated staffing needs.
- Maintained current knowledge of equal employment opportunity and affirmative action guidelines and laws.
Sr. Credentialing Specialist
MD Anderson Cancer Center
Houston
01.2019 - 09.2025
- Reviewed applications and verified qualifications of healthcare professionals for compliance.
- Coordinated with departments to gather necessary documentation for credentialing requests.
- Conducted regular audits of credentials to uphold institutional standards and regulations.
- Maintained accurate records in credentialing database to ensure data integrity.
- Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
- Processed re-credentialing applications for existing providers according to contractual requirements.
- Conducted background checks on potential providers utilizing various resources including state licensing boards, OIG and GSA Exclusion List, NPDB.
- Provided support in responding to inquiries from external parties regarding credentialing information.
- Participated in periodic audits of credentialing files to maintain compliance with applicable regulations and policies.
- Maintained detailed records of provider data in the credentialing database system.
- Coordinated with internal departments such as medical staff services or risk management to resolve any issues identified during the verification process.
- Participated actively in special projects or initiatives pertaining to improvement of operational efficiency within the department.
- Completed enrollments into Medicaid, Medicare and private insurance plans.
- Researched discrepancies between submitted provider data and verified sources when necessary.
- Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
- Processed documents and status-change requests, conducting follow up assessment regarding enrollment inquiries.
- Attended meetings and seminars related to healthcare industry regulations and trends.
- Served as a resource person for staff members seeking assistance in understanding complex regulatory requirements related to provider enrollment processes.
- Interacted regularly with representatives from health plans and commercial payers regarding credentialing matters.
- Performed initial review for new providers to determine eligibility for enrollment into the network.
- Assisted in developing and implementing departmental procedures related to provider enrollment and maintenance activities.
- Performed database queries, compiling information according to requests and logging logistics changes.
- Trained junior credentialing staff on best practices and company-specific procedures.
- Managed end-to-end provider credentialing process, ensuring compliance with industry standards.
- Facilitated communication between departments to resolve credentialing issues efficiently.
- Assisted in the accreditation process by gathering and submitting required documentation.
- Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
- Collaborated with legal department to ensure compliance with federal and state regulations.
- Prepared and submitted detailed reports on credentialing progress to management.
- Ensured strict confidentiality of provider information in accordance with HIPAA regulations.
- Liaised with insurance companies to complete provider enrollment and ensure billing capabilities.
- Participated in credentialing committees, presenting cases and making recommendations.
- Responded to verification inquiries from other healthcare organizations and insurance companies.
- Conducted thorough background checks and verified educational and professional qualifications.
- Updated credentialing software with new features to enhance process efficiency.
- Provided guidance and support to new providers throughout the credentialing process.
- Prepared or maintained employment records using human resources management system software.
- Conducted exit interviews and completed employment termination paperwork.
- Set up NPI numbers for providers and facilities and updated current profile information.
- Collaborated with internal teams regarding provider contracts and agreements.
- Analyzed employment-related data and prepared reports.
- Searched for qualified job candidates using computer databases, media advertisements or employee referrals.
- Hired employees and processed hiring-related paperwork.
- Addressed harassment allegations, work complaints or other employee concerns.
- Sourced, qualified and conducted screening interviews with job candidates.
- Maintained current knowledge of equal employment opportunity and affirmative action guidelines and laws.
Clinical Research Associate
Texas Children’s Hospital
Houston
12.2016 - 01.2019
- Conducted patient assessments and gathered relevant medical history information.
- Managed patient records using electronic health record systems efficiently.
- Prepared vaccines according to manufacturer's instructions; administered vaccinations per physician orders.
- Participated in quality assurance initiatives designed to ensure the delivery of safe and effective care to patients.
- Trained junior staff on clinical trial procedures and best practices.
- Assisted in preparing reports for stakeholders on study progress and findings.
- Reported to project manager for issues related to overall study status.
- Analyzed collected data for accuracy prior to database lock; identified discrepancies when necessary.
- Provided training on GCP standards to new personnel or existing staff members.
- Interacted with sponsors, CROs, investigators, vendors and subcontractors as needed.
- Coordinated the submission of regulatory documents to IRBs and ECs and other relevant authorities.
- Collected and authenticated data collection forms to read and interpret complex clinical protocols.
- Tracked enrollment status across multiple sites to ensure target goals were met in a timely manner.
- Attended investigator meetings to provide framework for successful research studies by establishing responsibilities.
- Assessed incoming source documentation for accuracy and completeness against case report forms.
- Checked electronic data capturing systems for integrity and compliance.
- Obtained site approval and compiled all vital documentation.
- Participated in internal audits related to clinical research operations processes.
- Communicated with vendors to deliver appropriate clinical supplies to key areas and meet ongoing operational demands.
- Developed and managed budgets for clinical trials according to study protocols.
Certified Pharmacy Technician
Kindred Hospital
Houston
12.2013 - 01.2017
- Executed data entry, managed inventory, compounded parenteral and I.V. mixtures, labeled I.V. solution bags, delivered I.V. medications to nursing floors, stocked automated Pyxis machine, verified order completeness to facilitate accurate and timely medication distribution.
- Prepared and dispensed medications for oncology patients, adhering to safety protocols to ensure patient safety and effective treatment.
- Assisted pharmacists in inventory management, ensuring consistent medication availability to support timely and effective patient care.
- Educated patients on proper medication usage and potential side effects to enhance adherence and safety.
Certified Pharmacy Technician
PharMerica Pharmacy
Houston
02.2011 - 01.2014
- Entered data accurately into company databases and management systems.
- Reviewed documents for completeness and compliance with standards.
- Maintained organized records for easy access and retrieval.
- Collaborated with team members to improve data accuracy and efficiency.
- Processed incoming data requests promptly and efficiently.
- Processed large volumes of data with accuracy and attention to detail.
- Resolved discrepancies in data through comprehensive research and communication.
- Entered large volumes of data quickly with a high degree of accuracy.
- Maintained client confidence by keeping information confidential.
- Organized billing and invoice data, prepared accounts receivable, and generated revenue reports to support audits.
- Completed accurate and efficient data entry and database updates to support business operations.
- Created spreadsheets for tracking incoming orders and outgoing shipments.
- Compiled, sorted, and verified electronic data against hard copies to support quality control efforts.
Certified Pharmacy Technician
Lone Star Pharmacy
Sugar Land
11.2008 - 02.2011
- Maintain organized electronic and physical records for easy access.
- Utilized software applications to enter, update, verify, and retrieve data, enhancing data management efficiency.
- Resolved problems related to incorrect or incomplete data entries.
- Verify and correct discrepancies in data entries.
- Conduct regular audits to ensure data integrity and quality.
- Collaborate with team members to ensure data consistency.
- Inputted data into computer system to ensure accuracy and completeness of records.
- Entered large volumes of data quickly with a high degree of accuracy.
- Performed data entry tasks including keying in numerical or alphanumerical information from source documents into databases.
- Reviewed database entries to verify regulatory compliance.
- Reviewed and updated account information in company computer system.
- Organized billing and invoice data, prepared accounts receivable, and generated revenue reports to facilitate audit processes.
- Completed accurate and efficient data entry and database updates to support business operations.
- Generated reports on discrepancies between physical counts and computer records.
- Compiled, sorted, and verified electronic data against hard copies to ensure quality control standards.
- Supported document reviews and auditing by locating and providing required data, reporting on input procedures and other relevant circumstances as necessary.
- Monitored changes in regulations that impacted recordkeeping processes.
- Performed high-volume 10-key data entry to maintain accurate records.
- Utilize software tools for efficient data management tasks.
Education
Diploma - Pharmacy Technician
Remington College Houston West Campus
Houston, TX07-2008
Bachelor’s - Science
Texas Southern University
Houston, TX05-2025
Associate - Liberal Arts
Houston Community College Central
Houston, TX05-2018
Skills
- Credentialing workflow management
- Credentialing processes
- Credentialing compliance standards
- Credentialing regulations
- Credentialing documentation
- Credentialing oversight
- Credentialing policy development
- License verifications
- Provider verification
- Credentialing record management
- HIPAA regulations
- HIPAA compliance
- Regulatory compliance
- Quality control processes
- Good clinical practices
- ICH-gCP guidelines
- Clinical documentation
- Documentation requirements
- SOPs understanding
- Documentation mastery
- Data management
- Research experience
- Research ethics
- Site operations
- Attention to detail
- Compliance auditing
- Training facilitation
- Stakeholder communication
- Team collaboration
- Leadership qualities
- Problem-solving aptitude
- Conflict resolution
- Client relations management
- Staff onboarding
- Problem-solving aptitude
- Conflict resolution
- Client relations management
- Staff onboarding
Certification
Texas State Board of Pharmacy
Accomplishments
American Society of Health System Pharmacist ASHP Pharmacy Technician
Timeline
Credentialing Specialist
Healix Infusion Pharmacy
10.2025 - Current
Sr. Credentialing Specialist
MD Anderson Cancer Center
01.2019 - 09.2025
Clinical Research Associate
Texas Children’s Hospital
12.2016 - 01.2019
Certified Pharmacy Technician
Kindred Hospital
12.2013 - 01.2017
Certified Pharmacy Technician
PharMerica Pharmacy
02.2011 - 01.2014
Certified Pharmacy Technician
Lone Star Pharmacy
11.2008 - 02.2011
Diploma - Pharmacy Technician
Remington College Houston West Campus
Bachelor’s - Science
Texas Southern University
Associate - Liberal Arts
Houston Community College Central