Detailed-oriented Credentialing Specialist with 20 + years of experience in managing provider credentialing processes. Experienced in credentialing 55 + providers across multiple specialties in KY, OH & IN to include Family Medicine, Women’s Health, Dental & Behavioral Health. I am hard working & dedicated with strong organizational skills.
▪ Manage provider & facility credentialing processes with expedition to ensure compliance with regulatory standards as a Federally Qualified Health Center.
▪ Conduct primary source verifications.
▪ Facilitate privileging applications for Chief Medical Officer, CEO & Board of Directors approval.
▪ Collaborate & coordinate communication with providers & payer organizations.
▪ Manage multiple priorities effectively resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
▪ Conduct audits of provider files ensuring all necessary documents are compliant with the Health Resources and Services Administration {HRSA} as well as the Federal Tort Claims Act {FTCA}.
▪ Demonstrate excellent problem-solving skills during the credentialing process.
▪ Enhance credentialing processes by developing a streamlined process for the documentation & verification procedures.