Sylvia Reyes
52 Hays Run Atoka,TN
Overview
12
12
years of professional experience
Work History
Health System Specialist (Credentialing)
Department of Veteran Affairs
Memphis, TN
02.2023 - Current
- Maintaining assigned NON-LIP and LIP files by tracking, documenting, and reviewing the credentialing and privileging into Excel Spreadsheet
- Coordinated and alerted the C&P Manager and Service Chiefs to resolve any issues identified during the credentialing and verification process.
- Ensure reference materials, procedures, policies, that are written instructions from the C&P manager and Chief of Staff are implemented and completing additional Credentialing and Privileging assigned duties and projects.
- Serve as a point of contact resource person, trainer to staff members seeking assistance in understanding complex requirements related Credentialing and Privileging.
- Researched credentialing discrepancies between submitted LIP and NON-LIP data and verified sources when necessary within VetPro software and Credentialing Forms.
- Maintained positive working relationship with fellow staff and management.
- Prioritized and organized tasks to efficiently accomplish credentialing and privileging service goals and deadlines.
- Ensuring LIP & NON- LIP credentialing and re-credentialing files are meeting deadline requirements.
- Updating and Verification of DEA, Licenses, Certifications, FSMB, NPDB, Education, Personal History for initial and renewals of Privileges
- Utilizes principles, methods, and tools of quality assurance and quality control to ensure that credentialing and privileging packets are properly completed, verified and meet requirements.
- Researched and maintain accurate information and records in VetPro and VISTA primary source verifications, licenses, education, board certifications, DEA, FSMB, NPDB, ECFMG.
- Appointed LIP Providers after Service Chief Committee Meeting and VISTA to complete the credentialing process.
- Enrolled DEA's and LIP's in the E-Prescribe database.
- Document in Excel, Microsoft, and Combination Database
- Updating the LIP and NON-LIP Operating Room and Combination Database
- Reviewed FPPE and the OPPE for the C&P Program are ready for Committee Board Meeting.
- Explained important processes to staff members regarding OPPE's and FPPES's during the recredentialing/renewal process.
- Utilized documents and assignment forms from USA Staffing system software for credentialing purposes.
- Maintains confidentially of all information and remain compliant with the Privacy Act.
- Provide guidance and advice to staff member and instructions on NON-LIP and LIP on required documentation to establish credentialing & privileges and other required information to verify an applicant.
- Work independently by collecting important data and make informed decisions on qualification of applicants during the credentialing and privileging process. To determines course of action and problem-solving.
- Sat on interview panel for new hires
- Graded Resumes obtained from Human Resources for hiring purposes.
- Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
- Attended meetings regarding Credentialing and Privileging related to policies, regulations, and trends within the VAMC.
- Demonstrated leadership by making improvements to work processes and helping to train others.
- Reviewed progress of trainees throughout their credentialing process of LIP and NON-LIP duration to ensure they meet requirements and identified areas for improvement with feedback.
Advanced Medical Support Assistant
Department of Veteran Affairs
Memphis, TN
08.2021 - 02.2023
- Scheduling, rescheduling, and cancelling return to clinic, telehealth appointments, consults
- Multi-tasking and answering a multi-phone lines
- Running Encounters and appointments and patient information in VISTA
- Strong knowledge in Medical terminology
- Coordinate Internal and external messages with Veterans through MyHealthVet
- Communicates with staff to expedite emergency requests
- Performs, maintains, accomplishes a variety of medical clerical and administrative tasks
- Answered phone calls and communicate with patients and providers via secure messaging to provide assistance, information and medical personnel access.
- Prioritizing and balancing work and patient flow and patient support
- Following policies, regulations, and establish processes per VHA process
- Assists in problem solving and resolving operational issues and patient concerns.
- Ensures observance of deadlines and coordination between patient and medical services
- Prepare reports in various formats and presenting data to various organizational levels
- Monitoring multiple software programs during work day, CPRS, VISTA GUI, VETLINK, LEAF, ICB excel spreadsheets
- Review provider orders on applications in CPRS and GUI, ensuring the patient is notified and scheduled.
- Assist in training new hires for Medical Support Assistant positions
Patient Service Representative
St Francis Medical Partners
Munford, TN
06.2019 - 07.2021
- Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
- Answered phone calls to provide assistance, information and medical personnel access to maximize office efficiency.
- Delivered direct and indirect patient care in accordance with physician practice policies.
- Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
- Entered patient information, including insurance, demographic and health history into system to keep all records up-to-date.
- Improved operations by working with team members and customers to find workable solutions.
- Training new hires and employees on system and daily functions
Ambulatory Office Assistant
Bassett Healthcare
Clinton, NY
01.2017 - 09.2017
- Handle tasks of organizing and maintaining medical forms and records
- Registering patients by following protocols of the organization
- Checking and verifying accuracy of medical record and insurance information of patient
- Handle tasks of referrals and procedure authorizations
- Answered phone calls to provide assistance, information and medical personnel access to maximize office efficiency.
- Entered patient information, including insurance, demographic and health history into software system and confirmed records were updated.
- Managed physician calendar, including scheduling patient appointments and procedures.
- Maintained office supplies inventory by checking stock and ordering new supplies as needed.
- Managed medical practice administrative needs to provide patient satisfaction.
Medical Assistant/Receptionist/Phlebotomist
A.S. Neurology PC
New Hartford, NY
08.2015 - 12.2016
- Monitored and filed all received information.
- Prior Authorizations
- Venipuncture and collecting specimens
- Assisted with properly processing records requests.
- Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
- Conducted patient intake interviews to collect medical information and insurance details.
- Answered multi-line phone system and directed callers to requested personnel and departments.
Medical Assistant/Receptionist
Adirondack Internal Medicine and Pediatrics
New Hartford, NY
05.2012 - 08.2015
- Answered phone calls to provide assistance, information and medical personnel access to maximize office efficiency.
- Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
- Entered patient information, including insurance, demographic and health history into system to keep all records up-to-date.
- Processed patient payments and scanned identification and insurance cards.
- Conducted patient intake interviews to collect medical information and insurance details.
- Supported administrative and healthcare staff, providing order fulfillment and inventory management services to ease operations.
Education
Bachelor of Science - Health Information Management
Southern New Hampshire University
Hooksett, NH08-2021
High School Diploma -
Thomas R. Proctor High School
Utica, NY06-2010
Some College (No Degree) -
Mohawk Valley Community College - Utica
Utica, NYSkills
- Bilingual
- Organized, Detail-Oriented
- Outstanding ability to work well independently and with others
- Excellent customer service skills
- Good written and oral communications
- Computer skills
- Strong knowledge of Medical Terminology
- Interpersonal skills
- Problem-solving
- Time management
- Adjustment to situations
References
References per Request
Timeline
Health System Specialist (Credentialing)
Department of Veteran Affairs
02.2023 - Current
Advanced Medical Support Assistant
Department of Veteran Affairs
08.2021 - 02.2023
Patient Service Representative
St Francis Medical Partners
06.2019 - 07.2021
Ambulatory Office Assistant
Bassett Healthcare
01.2017 - 09.2017
Medical Assistant/Receptionist/Phlebotomist
A.S. Neurology PC
08.2015 - 12.2016
Medical Assistant/Receptionist
Adirondack Internal Medicine and Pediatrics
05.2012 - 08.2015
Bachelor of Science - Health Information Management
Southern New Hampshire University
High School Diploma -
Thomas R. Proctor High School
Some College (No Degree) -
Mohawk Valley Community College - Utica
Similar Profiles
MARIANNE GONTAMARIANNE GONTA
Vocational Rehabilitation Counselor at U.S. Department of Veteran Affairs, Veteran Benefits AdministrationVocational Rehabilitation Counselor at U.S. Department of Veteran Affairs, Veteran Benefits Administration
Rebecca McKeeRebecca McKee
Legal Administrative Specialist at Department of Veteran Affairs, Veteran Benefits AdministrationLegal Administrative Specialist at Department of Veteran Affairs, Veteran Benefits Administration
Joseph HarrisonJoseph Harrison
Senior Police Officer at Department of Veteran AffairsSenior Police Officer at Department of Veteran Affairs
Frances GarofanelloFrances Garofanello
Supervisory, Human Resources Specialist at Department of Veteran Affairs, Veterans Benefits AdministrationSupervisory, Human Resources Specialist at Department of Veteran Affairs, Veterans Benefits Administration
Justin AndresJustin Andres
Field Service Supervisor/Associate Project Manager at S&MEField Service Supervisor/Associate Project Manager at S&ME