Wendy Salinas
Mesa,AZ
Summary
Efficient Credentialing Specialist known for high productivity and the ability to complete tasks swiftly. Specialize in credential verification, compliance management, and process improvement. Excel in communication, problem-solving, and organization, ensuring smooth credentialing processes and effective collaboration with healthcare professionals.
Overview
12
12
years of professional experience
Work History
SR Credentialing Specialist Lead
Aetna Medicaid
Phoenix, AZ
03.2016 - 09.2024
- Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
- Performed initial review for new providers to determine eligibility for enrollment into the network.
- Ensured timely completion of credentialing processes by providing guidance to providers on required documentation.
- Processed re-credentialing applications for existing providers according to contractual requirements.
- Provided support in responding to inquiries from external parties regarding credentialing information.
- Researched discrepancies between submitted provider data and verified sources when necessary.
- Prepared correspondence for various departments concerning credentialing updates or requests for additional information.
- Helped to develop learning guides for all aspects of the job.
- Spearheaded the instruction and education of New Hires about the credentialing/re-credentialing protocols.
- Help in developing standard processes for the credentialing Quick Base reports.
- Implemented updated policies for credentialing based on contracts.
- Trained junior credentialing staff on best practices and company-specific procedures.
- Scheduled or conducted new employee orientations.
Home Health Aide
Bright Star Home Health
Tempe, AZ
02.2013 - 01.2016
- Assisted with personal care activities, such as bathing, dressing and grooming.
- Provided companionship and monitored health condition of clients.
- Transported clients to doctor appointments and social events.
- Prepared meals and snacks according to prescribed diets.
- Collected information about conditions and treatment plans from caregivers, nurses, and doctors.
- Assisted in ambulation and exercise routines for clients.
- Helped clients move in bed, stand or walk using proper body mechanics techniques.
- Changed bed linens and maintained a clean-living environment for the client's safety.
- Recorded daily notes about client conditions, treatments provided, and progress made.
- Administered medications as instructed by physician or nurse practitioner.
- Reported any changes in the client's physical or emotional condition to supervisor immediately.
- Monitored temperature, pulse rate, and blood pressure.
- Recorded daily notes about client conditions, treatments provided, and progress made.
Education
Bachelor of Arts - Business Administration
University of Phoenix
Tempe, AZ02-2014
Associate of Arts - Business Administration
University of Phoenix
Tempe, AZ06-2012
Skills
- Document Review
- Database Maintenance
- Application management
- Facility credentialing
- Practitioner credentialing
- Quick Base savvy
- QNXT
- EPDB (Rumba Mainframe)
- OIG Verifications
- SAM Verifications
- NPESS Verifications
- CAQH experience
- Excell
- Word
- Sales Force (PRMS)
- License verifications
Timeline
SR Credentialing Specialist Lead
Aetna Medicaid
03.2016 - 09.2024
Home Health Aide
Bright Star Home Health
02.2013 - 01.2016
Bachelor of Arts - Business Administration
University of Phoenix
Associate of Arts - Business Administration
University of Phoenix