Tirzah Hardy
MARYSVILLE
Summary
Dedicated credentialing specialist with extensive experience managing provider applications and ensuring compliance with regulatory standards. Proven ability to maintain accurate provider records and streamline enrollment processes, contributing to operational efficiency and provider satisfaction.
Overview
19
19
years of professional experience
Work History
Credentialing Representative
Colorado Kidney Care
Denver
08.2019 - Current
- Prepare, submit and track provider credentialing and payer enrollment applications for new and existing clinicians, MDs, PAs, and NPs.
- Manage and maintain CAQH, NPPES, PECOS and payer portal profiles.
- Oversee Medicare/Medicaid enrollment and revalidation processes, ensuring compliance with state-specific requirements.
- Ensure all providers’ files are audit ready and compliant with regulatory and accreditation standards.
- Maintain and update provider records across credentialing platforms and internal databases.
- Track and manage expirable credentials (license, DEA, malpractice insurance, board certifications).
- Coordinate hospital privileging applications and reappointment cycles, as applicable.
- Monitor applications statuses and proactively follow up with payers, licensing boards, and hospitals.
- Track and update provide demographics changes with payers (e.g., address, tax ID, panel status).
- Serve as a liaison between providers, billing, and insurance carriers to resolve credentialing or billing issues.
- Update director of operations on changes in licensing laws and credentialing processes.
- Assists President with data or research for company projects regarding privileging of group.
Credentialing Coordinator
Colorado Kidney Care
Denver
11.2016 - 07.2019
- Completes provider credentialing/re-credentialing applications for 50+ providers; monitors applications and follows-up as needed.
- Coordinates the various external functions associated with credentialing, re-credentialing and privileging of Colorado Kidney Care health care providers.
- Represents Colorado Kidney Care in the credentialing/privileging process with hospitals, government agencies, and health plan credentialing departments as necessary.
- Compiles and maintains current state license, DEA certificates, malpractice and any other required credentialing documents for all providers.
- Set up and maintains provider information in online credentialing databases and systems.
- Tracks license and certification expiration for all providers to ensure timely renewals.
- Identify issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
- Maintain accurate payer rosters, including, accurate practice and mailing addresses are current with health plans, agencies and other entities such as CAQH, PECOS, Medicare and so forth.
- Enroll providers in any health plans to receive payment for outstanding claims.
- Maintain confidentiality at all times.
- Assists Manager to devise implementation strategy, work plans, and agendas facilitating efficiency.
Dialysis Support Coordinator
Colorado Kidney Care
Denver
09.2015 - 10.2016
- Schedule dialysis appointments for units in EMR.
- Prep dialysis notes for each provider per detailed request.
- Assist with ongoing maintenance of unit's appointments in EMR such as cancellations, reschedules patients moving, and coming off of dialysis etc.
- Coordinate PD and Home dialysis monthly schedules for units.
- Maintain dialysis rosters per unit and provider.
- Process hospital transfer summaries that come from provider.
- Obtain medical records from hospital portals per requests; attach in chart and fax to unit.
- Support the Dialysis Help Team with email requests and responding to questions.
Scheduling Coordinator-Administrative Assistant
Colorado Kidney Care
Denver
02.2010 - 09.2015
- Patient scheduling for 40 physicians within 10 offices.
- Developed and implemented policies and procedures to enhance department operations.
- Provides onsite training for staff in department.
- Acts as liaison between department and Regional Clinical Manager.
- Requested, reviewed, and attached records into EHR to ensure comprehensive patient documentation.
- Assisted billing department with referrals and verification.
- Created correspondence, spreadsheets and reports for department.
- Triage incoming phone calls and directed to relevant personnel.
- Ensured operational readiness of office equipment by coordinating maintenance and repair with vendors and contractors.
- Assist with setting up conferences and coordinating luncheons.
- Assisted in mass mailings regarding company changes and policies.
Scheduling Coordinator
Colorado Gastroenterology
09.2008 - 01.2010
- Coordinated patient appointment scheduling at front desk to enhance patient flow.
- Organized scheduling of surgical procedures and related appointments.
- Check in/Check out patients.
- Triage phone inquiries to prioritize patient concerns and facilitate timely responses.
- Requested patient records from various departments for processing.
- Compiled and organized patient charts for efficient access by providers.
- Entered data into electronic health records to ensure accuracy and compliance.
- Assisted Medical Records Department with records requests.
Office Coordinator/Executive Administrative Assistant
Dr. Craig Bushong Psychiatrist
Houston
10.2007 - 08.2008
- Responded to incoming phone calls from patients and directed them accordingly.
- Scheduled patients.
- Entered patient information into electronic health records with accuracy.
- Processed patient prescription refill requests in collaboration with physicians.
- Assembled daily deposits.
- Supported billing team by verifying insurance details for patient claims.
- Facilitated collection of outstanding payments from patients to uphold financial accuracy.
- Organized and archived patient records to ensure easy retrieval and compliance.
- Coordinated meetings and luncheons.
- Supported recruitment efforts by screening candidates and scheduling interviews.
- Managed physician calendar.
- Maintained strict confidentiality.
- Ensured all office equipment operated effectively and coordinated maintenance with vendors.
Education
GED -
Houston Community College
Houston, TXMassage 1 Graduate -
Alaska Institute of Oriental Medicine, Acupuncture and Massage Therapy
Anchorage, AKSkills
- EClinical Works
- Credential My Doc
- Verity Stream
- MD-App portals
- Medicaid enrollment
- Microsoft Office
- Excel
- Word
- PowerPoint
- Outlook
- Adobe
- Scheduling
- Calendar management
- Critical thinking
- Self-starter
Timeline
Credentialing Representative
Colorado Kidney Care
08.2019 - Current
Credentialing Coordinator
Colorado Kidney Care
11.2016 - 07.2019
Dialysis Support Coordinator
Colorado Kidney Care
09.2015 - 10.2016
Scheduling Coordinator-Administrative Assistant
Colorado Kidney Care
02.2010 - 09.2015
Scheduling Coordinator
Colorado Gastroenterology
09.2008 - 01.2010
Office Coordinator/Executive Administrative Assistant
Dr. Craig Bushong Psychiatrist
10.2007 - 08.2008
GED -
Houston Community College
Massage 1 Graduate -
Alaska Institute of Oriental Medicine, Acupuncture and Massage Therapy