Stephanie Roberts
Miramar,FL
Summary
Dedicated and meticulous Credentialing Specialist with over 4 years of experience in credentialing and re-credentialing healthcare providers. Expert in ensuring compliance with state, federal, and accrediting body regulations, including NCQA and JCAHO standards. Proficient in managing credentialing databases, maintaining precise documentation, and cultivating positive relationships with healthcare providers. Renowned for exceptional attention to detail, strong problem-solving skills, and excellent communication. Committed to optimizing credentialing processes and improving organizational efficiency.
Overview
13
13
years of professional experience
Work History
Oncology Patient Advocate
Memorial Cancer Institute
Pembroke Pines, FL
04.2023 - Current
- Worked effectively with staff from all departments to coordinate resolutions.
- Responded to patient concerns and questions with compassionate and knowledgeable services.
- Educated patients and families on healthcare options and financial support resources.
- Facilitated communication between patients, families and healthcare providers to support comprehension.
- Monitored patient progress and provided emotional support.
Credentialing Specialist Assistant
Community Care Plan
03.2021 - 04.2023
- Responsible for the timely and compliant credential and re-credentialing process for providers, including physicians and healthcare delivery organizations, according to State and Federal requirements
- Provide credentialing and re-credentialing to Community Care Plan providers with attention to accuracy and detail
- Maintained confidentiality of provider information, as well as organize, maintain, and verify all aspects of the process, and maintain current providers files.
- Followed up on the status of applications and missing documents for physicians and other allied providers.
- Conducted primary source verifications such as background checks and board certifications.
- Received and evaluated applications to look for missing and inaccurate information.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
Patient Financial Service Representative
Memorial Primary Care East Hollywood
08.2019 - 03.2021
- Ensures that all necessary demographic, billing, and clinical information is obtained and entered with timeliness and accuracy in Epic Tapestry System
- Communicates with physician’s and their staff, nursing unit staff, and/or other appropriate personnel to exchange necessary information
- Verified insurance benefits and obtains pre-certification/authorization as necessary
- Determines and accepts required payments, including but not limited to co-pays and deductibles
- Performed access functions for all patients presenting for services.
- Entered client details and notes into system for interdepartmental access and review
Patient Care Assistant
Joe DiMaggio Children’s Hospital
11.2016 - 07.2018
- Attended to patient and family's immediate needs and concerns by acknowledging and providing required attention.
- Recognized and reported abnormalities or changes in patients' health status to case manager.
- Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Recorded temperature, blood pressure, pulse, or respiration rate as directed by medical or nursing staff.
- Maximized patient satisfaction by helping individuals carry out personal tasks such as dressing and walking.
- Remained alert to problems or health issues of clients and competently responded.
Patient Care Assistant
Memorial Regional Hospital
04.2016 - 11.2016
- EKGs Specimen Collection , Vital Signs Patient Registration Front Desk Duties Phlebotomy Review and Assess data Computer Applications Detail & Results Oriented HIPAA Compliance
- Scheduling Appts Telephone Triage Charting/Records Mgmt
- Prescription Refills Interact with service providers to assist with claims processing, Take vital signs and collect specimen
- Observe and report any changes in patient condition
- Assist with personal cleanliness, oral hygiene, making beds and straightening rooms
- Setup apparatus and monitor intake/output of patients
- Transport patients to other departments and operation unit of the hospital
- Distribute patient education materials
- Maintain current patient information on tracking system
Member Service Representative (Advocate II)
Altegra Health
06.2014 - 03.2016
- Meet production/departmental and quality goals by conducting telephonic outreach activities to review and assess health plan member’s eligibility
- Review and analyze health plan member correspondence and/or inquiries for the purpose of transferring the most qualified cases
- Maintain and follow-up of inbound and processed correspondence and/or inquiries from Altegra's Health Outreach
- Maintain current knowledge of Medicare and Medicaid state and federal regulatory requirements
- Adhere to strict compliance of all aspects of Altegra Health's Outreach Operations
- Maintained updated knowledge of internal processes and industry best practices to optimize service delivery.
Certified Nursing Assistant
Kidz Korner
Plantation, FL
02.2012 - 06.2014
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing and teeth brushing.
- Checked patient vitals such as temperature, blood pressure and blood sugar levels.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
Certified Nursing Assistant
Broward Children's Center
Pompano Beach, FL
07.2011 - 02.2012
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing and teeth brushing.
- Checked patient vitals such as temperature, blood pressure and blood sugar levels.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Offered immediate assistance in emergency and routine paging situations to evaluate needs and deliver care.
Education
Associates of Arts - Prenursing Studies
Miami Dade College North Campus
11380 NW 27th Ave, Miami Fl04.2023
Certificate of Completion, Licensed Practical Nursing Program - LPN Certificate
Sheridan Vocational Technical Center
Hollywood, FL01.2021
Certified Nursing Assistant Jan. -
2012
Skills
- Excellent written and verbal communication skills
- Proficient with Microsoft Office
- Research and Analytical Skills
- Meticulous Attention to Detail
- Experience in credentialing and re-credentialing healthcare providers
- Knowledge of credentialing standards and requirements
- Experience with credentialing management systems
- Schedule Management
- Multitasking and Time Management
- Professional and Courteous
Timeline
Oncology Patient Advocate
Memorial Cancer Institute
04.2023 - Current
Credentialing Specialist Assistant
Community Care Plan
03.2021 - 04.2023
Patient Financial Service Representative
Memorial Primary Care East Hollywood
08.2019 - 03.2021
Patient Care Assistant
Joe DiMaggio Children’s Hospital
11.2016 - 07.2018
Patient Care Assistant
Memorial Regional Hospital
04.2016 - 11.2016
Member Service Representative (Advocate II)
Altegra Health
06.2014 - 03.2016
Certified Nursing Assistant
Kidz Korner
02.2012 - 06.2014
Certified Nursing Assistant
Broward Children's Center
07.2011 - 02.2012
Associates of Arts - Prenursing Studies
Miami Dade College North Campus
Certificate of Completion, Licensed Practical Nursing Program - LPN Certificate
Sheridan Vocational Technical Center