Tyquanna Daley
Credentialing Professional
Philadelphia,PA
Summary
Dynamic Credentialing Manager with extensive experience at Physician Management Resources, adept at leveraging CAQH and Modio to enhance provider enrollment processes. Proven track record in cultivating client relationships and optimizing health insurance plans, resulting in increased referrals and practice scalability across states. Strong analytical skills paired with exceptional communication abilities.
Overview
21
21
years of professional experience
9
9
years of post-secondary education
Work History
Remote Credentialing Manager
Physician Management Resources
Needham Heights, MA
01.2023 - 12.2025
- Sourced optimal health insurance plans to maximize profits and enhance client recommendations.
- Cultivated strong client relationships, resulting in referrals based on service satisfaction.
- Collaborated with clients to strategically scale practices across multiple states efficiently.
- Utilized Modio, CAQH, and Availity for managing provider demographics and coordinating with health insurance plans.
Remote Credentialing Specialist
Heal Doctors, PC
Los Angeles, CA
03.2020 - 01.2023
- Track/update new hires via Monday.com (productivity app)
- Onboard/Maintain/Offboard employee credentialing data via MDStaff
- Update medical provider data in CAQH and Availity
- Submit enrollment applications/rosters to Medicaid, Medicare PECOS and contracted insurance plans
- Humana DCE (Direct Contract Entity) report submissions
- Used Slack to communicate with the team and used the project management Asana
- Healthcare Tech Company
HR Generalist/Credentialing Specialist
Comprehensive House Call Medicine, PC
Brooklyn, NY
05.2015 - 03.2020
- Credentialing/Payor Enrollment: submitted enrollment applications and/or complete managed care rosters.
- Post Jobs: met with hiring managers, researched compensation, posted jobs on job boards
- Sourced: candidates and updated ATS, and follow up with hiring manager for feedback
- Onboarding: Sent out required HR documents i.e. Offer Letters, Compliance documents i.e. W4, 1-9 verifications, and handbook
- Employee Relations: Cobra, LOA, Unemployment, Benefits
- Multi-Specialty Home Visit Medical Group (Acquired by Heal Doctors, PC)
Senior Credentialing Coordinator
Amida Care
New York, NY
01.2013 - 04.2015
- Processed Ancillary/Facility/Provider applications (Article 28/FQHC) and Provider (HIV PCP, PCP, Behavioral Health and Specialist)
- Loaded contract data in Amida Care database after Chief Medical Officer approves providers for billing, member services and other
- Issued provider ID numbers and effective date to providers via Welcome Letters.
- Special Needs Health Insurance Plan
Credentialing Specialist/Recruiter
Housing Works
Brooklyn, NY
10.2009 - 01.2013
- Managed the credentialing/contracting process
- Sourced candidates via LinkedIn, ADP Recruitment (Applicant Tracking System), Facebook, Bullhorn, job fairs, and alumni associations for administrative and clinical positions
- Created job posts using ADP Recruitment module, coordinated the start dates of new hires and assisted and drafted official offer letters
- A Socioeconomic Non-profit organization
Supervisor, Medical Staff
The Brooklyn Hospital Center
Brooklyn, NY
01.2008 - 10.2009
- Provided demographic reports to Finance, Clinical, Risk Management, and Administration
- Analyzed and input data in Visual Cactus to update provider demographics for board approval letters to be created
Provider Relations, Credentialing Specialist
Health Plus
Brooklyn, NY
10.2004 - 01.2008
- Conducted primary source verification of provider files
- Loaded approved provider files in Facets and sent out welcome letters
- Health Insurance Plan acquired by Amerigroup-Empire BlueCross BlueShield
Education
Bachelor of Arts - Liberal Arts
City College of New York
New York (City), NY 08.2003 - 05.2005
Associate of Arts - Liberal Arts
Borough of Manhattan Community College
New York (City), NY 08.1996 - 08.2003
Skills
- Microsoft Office Suite
- Medicare PECOS
- ADP recruitment module
- CAQH credentialing database
- FACETS contract loading
- Visual Cactus credentialing database
- MDStaff credentialing database
- Modio credentialing database
- Mondaycom project management
Timeline
Remote Credentialing Manager
Physician Management Resources
01.2023 - 12.2025
Remote Credentialing Specialist
Heal Doctors, PC
03.2020 - 01.2023
HR Generalist/Credentialing Specialist
Comprehensive House Call Medicine, PC
05.2015 - 03.2020
Senior Credentialing Coordinator
Amida Care
01.2013 - 04.2015
Credentialing Specialist/Recruiter
Housing Works
10.2009 - 01.2013
Supervisor, Medical Staff
The Brooklyn Hospital Center
01.2008 - 10.2009
Provider Relations, Credentialing Specialist
Health Plus
10.2004 - 01.2008
Bachelor of Arts - Liberal Arts
City College of New York
08.2003 - 05.2005
Associate of Arts - Liberal Arts
Borough of Manhattan Community College
08.1996 - 08.2003