Teresa Hayes
League City,TX
Summary
- Articulate Credentialing Coordinator with exemplary critical thinking and decision-making talents. An energetic professional with more than 20 years' requesting credentialing documents from providers. Ready to apply my talents in credentialing and document workflows with a new organization. Teresa is a multitasking professional skilled in file efficiency and database integrity. I am a resourceful Credentialing Coordinator with a background in tracking the expiration of practitioner documents. Teresa is an experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving, and communication skills.
Overview
5
5
years of professional experience
Work History
Credentialing Coordinator
Caris
03.2021 - Current
- Reviews and streamlines processes and workflows, using automation, where appropriate.
- Participate in the development and implementation of credentialing processes and procedures and provide input regarding process improvement.
- Process dinner program contracts and assist the legal department with any questions.
- Ensures duplicates are merged in Salesforce.
- Process over ten contracts a month.
Medical Services Professional Contractor
The Hardenbergh Group
09.2021 - 09.2023
- Responsibilities includes processing of applications for appointment and reappointment, take meeting attendance, reviews applications for completeness
- Provides customer service in excellence to medical staff and personnel.
- Improved project efficiency by streamlining communication channels and optimizing resource allocation.
- Reduced client complaints by implementing a more effective customer service strategy.
Credentialing Specialist Contractor
Molina Healthcare
03.2021 - 08.2021
- Prepare files for credentialing committee, Coordinate with network team to review and approve cred documentation Ongoing monitoring of providers in network for items such as sanctions and license revocations Oversight of recredentialing process and termination of providers who fall out of compliance Review and approve providers for expedited credentialing in alignment with Texas Insurance/Administration codes Align with provider data load team to ensure congruence in the contract to in network process.
Credentials Coordinator
MD Anderson
05.2019 - 02.2021
- PResponsible for credentialing activities related to any required provider according to institutional and regulatory standards by conducting primary source verification and outside agency queries
- This includes the data entry portion of the process
- This includes but is not limited to initial credentialing, recredentialing, additional privileges, modification of privileges, change of departmental assignment or other credentialing/privileging activities
- Provides administrative support for assigned Medical Staff Committees of the Medical Staff
- Serves as Departmental Liaison Serves as MSCS liaison to administrative support staff and providers associated with clinical department for coordinating credentialing of potential candidates/recredentialing for clinical staff regarding membership and/or privileges
- Effectively coordinate, integrate, and communicate information and services within the department and with other departments such as practitioner privileges, privileging criteria and other content surrounding credentialing activities.
- Processed 25- 30 initial appointments and 60 -70 reappointments monthly.
Education
B.S. Healthcare Administration -
University of Phoenix
Scottsdale, AZ06.2023
Skills
- Medical Services Professional with over 20 years of experience, with a broad credentialing career ranging from military credentialing, hospital, managed care, and ambulatory Roles have ranged from Credentialing Clerk to Medical Staff Coordinator
- Proficiency in Cactus, MDStaff, Midas, Echo, etc
- Re-Credentialing Processes
- Microsoft Word
- Organization and Time Management
- Flexible and Adaptable
- Teamwork and Collaboration
- Attention to Detail
Accomplishments
Creating the first palliative care privileges for Shriner’s Galveston. Second in the entire Air Force to implement Department of Defense credentialing software to be used to credential Air Force Medical Staff globally. Numerous hours were spent entering 500 medical staff members into the database.
Additional Qualifications
Software / Technology Proficiency: Echo, MSOW, Visual Cactus, MSOW E-Delineate Module, Microsoft Office – Outlook, Word, PowerPoint, MS Teams, Zoom, WebEx and Excel
Military
1994-1998 (Honorable Discharge)
Affiliations
- Sigma Gamma Rho Sorority, Inc.
Timeline
Medical Services Professional Contractor
The Hardenbergh Group
09.2021 - 09.2023
Credentialing Coordinator
Caris
03.2021 - Current
Credentialing Specialist Contractor
Molina Healthcare
03.2021 - 08.2021
Credentials Coordinator
MD Anderson
05.2019 - 02.2021
B.S. Healthcare Administration -
University of Phoenix
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