Susan Craig
Provider Data Specialist
Champaign,IL
Summary
Efficient Provider Data Specialist known for productivity and swift task completion. Skilled in data management, quality control, and process improvement. Excel at collaboration, problem-solving, and adaptability, ensuring seamless operations in fast-paced environments.
Overview
29
29
years of professional experience
Work History
Provider Data Specialist-Remote
Village Medical
Champaign, IL
08.2022 - 11.2025
- Processed updates and terminations across multiple channels efficiently.
- Collaborated with credentialing and IT teams to resolve data discrepancies.
- Applied HIPAA standards to safeguard sensitive information.
- Maintained provider data accuracy in healthcare databases.
- Reviewed and validated provider information for compliance standards.
Provider Data Analyst-Hybrid
Health Alliance Medical Plans / CarleHealth
04.2020 - 07.2022
- Ensured the accuracy of the provider directory and demographics.
- Partnered with LexisNexis to provide data updates.
- Conducted audits to resolve discrepancies and maintain compliance.
- Assisted in resolving discrepancies in provider information for timely updates.
Claims Analyst
Health Alliance Medical Plans / CarleHealth
05.1997 - 04.2020
- Processed Medicare and Medicaid claims (HCFA, UB-04) with a focus on compliance.
- Audited claims for accuracy to adhere to regulatory standards.
- Monitored workloads, ensuring the timely processing of all claims.
- Verified customer documents to maintain information accuracy.
Electronic Medical Records Specialist
Carle Foundation Hospital
Urbana, IL
02.2005 - 11.2005
- Partnered with the team to transition patient paper medical records into the EMR system
- Trained staff on best practices for electronic documentation.
- Reviewed medical records for accuracy and completeness regularly.
- Assisted in the development of training materials for EMR users.
Education
Diploma -
Centennial High School
Champaign, ILLiberal Arts coursework -
Parkland Community College
Champaign, ILSkills
- Provider data management
- Data Entry
- Claims processing and reporting
- Microsoft Office Suite proficiency
- Salesforce and SharePoint expertise
- HIPAA compliance and data integrity
- Team collaboration and communication
- Organizational and analytical skills
- Attention to detail and time management
- Medicaid and Medicare knowledge
- Problem-solving and decision-making
- Professionalism and adaptability
- Verification and testing
Accomplishments
• Reduced provider data errors by collaborating with IT and credentialing teams to resolve discrepancies.
• Streamlined Medicare/Medicaid claims processing, improving turnaround times and compliance.
• Enhanced reporting efficiency by leveraging Excel training to generate management reports.
• Streamlined Medicare/Medicaid claims processing, improving turnaround times and compliance.
• Enhanced reporting efficiency by leveraging Excel training to generate management reports.
Timeline
Provider Data Specialist-Remote
Village Medical
08.2022 - 11.2025
Provider Data Analyst-Hybrid
Health Alliance Medical Plans / CarleHealth
04.2020 - 07.2022
Electronic Medical Records Specialist
Carle Foundation Hospital
02.2005 - 11.2005
Claims Analyst
Health Alliance Medical Plans / CarleHealth
05.1997 - 04.2020
Diploma -
Centennial High School
Liberal Arts coursework -
Parkland Community College