Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Stephen Nwose

Mesquite

Summary

Experienced credentialing specialist with over 5 years of expertise in provider enrollment, medical staff credentialing, and compliance. Adept at managing accreditation processes, ensuring regulatory adherence, and streamlining documentation workflows. Proven track record in supporting healthcare organizations to meet industry standards while providing exceptional service to providers.

Overview

3
3
years of professional experience
1
1
Certification

Work History

Provider Enrollment Coordinator

XIFIN
08.2024 - Current
  • Enhanced communication with providers by promptly addressing inquiries and concerns.
  • Maintained comprehensive records of enrolled providers, enabling easy access to information for internal stakeholders.
  • Increased departmental efficiency by regularly updating team members on changes in policies, procedures, or regulations affecting provider enrollment.
  • Assisted in reducing application processing time by efficiently reviewing and verifying provider credentials.
  • Maintained up-to-date knowledge of industry regulations, including NCQA, URAC, and CMS standards.
  • Facilitated the process of provider enrollment in multiple insurance networks and managed direct communication with carriers and regulators.
  • Improved data accuracy in the enrollment system through meticulous attention to detail during data entry.

Credentialing Analyst

Pacific Dental Services
01.2022 - 08.2024
  • Expedited the onboarding process for new providers by accurately verifying their education, training, experience, certifications, and licenses within strict timelines.
  • Collaborated with medical staff to gather necessary documentation for timely processing of provider applications.
  • Implemented regular training sessions to keep team members informed about relevant laws, policies, and procedures related to healthcare credentialing.
  • Troubleshot issues with electronic applications, quickly identifying problems and implementing solutions to maintain workflow efficiency.
  • Cultivated strong working relationships with various regulatory agencies by attending conferences, participating in industry forums, and staying abreast of changes in legislation that could impact our clients'' businesses or operations.
  • Assisted in the preparation and submission of all necessary documentation for initial credentialing and re-credentialing processes.

Education

Bachelor of Science - Health Administration

Texas State University
San Marcos, TX
05-2020

Skills

  • HIPAA compliance
  • Claims processing
  • Insurance verification
  • Audit preparation

Certification

  • Lean Six Sigma - Certified Greenbelt.

Timeline

Provider Enrollment Coordinator

XIFIN
08.2024 - Current

Credentialing Analyst

Pacific Dental Services
01.2022 - 08.2024

Bachelor of Science - Health Administration

Texas State University

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