YOLANDA GREEN
Phoenix,AZ
Summary
Proven leader in healthcare credentialing, adept at streamlining processes for efficiency and compliance, notably at Cigna Healthcare/Evernorth Care Group. I've enhanced provider onboarding and ensured rigorous adherence to healthcare regulations, achieving significant improvements in productivity and quality assurance. Experienced administrative professional with over 15+ years in provider credentialing services. Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
12
12
years of professional experience
Work History
Credentialing Analyst Lead
Cigna Healthcare/Evernorth Care Group
05.2014 - 02.2024
- Successfully resolved complex issues regarding licensing discrepancies or other concerns involving provider qualifications.
- Contributed to a positive working environment by collaborating with team members and sharing expertise on credentialing processes.
- Completed comprehensive background checks, ensuring all candidates met company standards for quality care provision.
- Collaborated with medical staff to gather necessary documentation for timely processing of provider applications.
- Expedited the onboarding process for new providers by accurately verifying their education, training, experience, certifications, and licenses within strict timelines.
- Ensured accuracy in data entry by carefully reviewing applicant information before inputting it into the system.
- Assisted in maintaining an updated database of credentialed providers, allowing for quick access to essential information when needed by senior management or other departments within the organization.
- Enhanced department productivity with proper organization and timely completion of tasks.
- Supported quality assurance initiatives by conducting ongoing reviews of internal procedures and making recommendations for improvements as needed.
- Implemented regular training sessions to keep team members informed about relevant laws, policies, and procedures related to healthcare credentialing.
- Troubleshot issues with electronic applications, quickly identifying problems and implementing solutions to maintain workflow efficiency.
- Developed user-friendly guides for healthcare professionals seeking credentialing assistance, streamlining their experience while ensuring compliance with internal protocols and external regulations.
- Maintained up-to-date knowledge of industry trends, best practices, and regulatory changes to ensure optimal efficiency within the credentialing department.
- Managed strict deadlines effectively, prioritizing tasks and efficiently allocating resources to ensure optimal productivity.
- Streamlined the credentialing process by implementing efficient tracking systems and maintaining accurate records.
- Cultivated strong working relationships with various regulatory agencies by attending conferences, participating in industry forums, and staying abreast of changes in legislation that could impact our clients'' businesses or operations.
- Ensured compliance with state regulations and accreditation standards by conducting thorough audits of credentials files.
- Served as a key liaison between healthcare providers and insurance companies, ensuring ongoing accuracy of information exchange.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Prepared records for site visits and file audits.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Conducted primary source verifications such as background checks and board certifications.
Senior Medical Staff Coordinator
Banner Desert Medical Center
07.2012 - 05.2014
- Contributed to facility accreditation efforts by preparing necessary documentation and coordinating site visits from accrediting agencies.
- Streamlined credentialing processes for faster onboarding of new medical staff members.
- Collaborated with human resources to manage employee relations issues, resulting in improved morale and retention rates among medical staff.
- Coordinated interdepartmental committee meetings for effective collaboration on hospital-wide initiatives.
Education
Associate of Science - Health Administration
AXIA/University of Phoenix
Phoenix, AZ07.2007
Skills
- Familiar with various credentialing databases (Morrisey, Cactus ect)
- Knowledge of regulatory credentialing requirements
- Experience with credentialing of healthcare facilities
- MS Office Product Sufficient Knowledge
Timeline
Credentialing Analyst Lead
Cigna Healthcare/Evernorth Care Group
05.2014 - 02.2024
Senior Medical Staff Coordinator
Banner Desert Medical Center
07.2012 - 05.2014
Associate of Science - Health Administration
AXIA/University of Phoenix
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