Yolanda Guerrero

Excellent organizational and proficiency in the use of Medical Staff Database and related programs. Self Starter with an ability to work effectively in a high-pressure environment. Experience background in the healthcare and professional setting strong work ethic, conscientious, team player. Motivated Credentialing Coordinator proudly offering many years of utilizing exemplary time management skills in office environments. An enthusiastic individual with a strong knowledge of initial credentialing of practitioners. Composed and driven with great communication skills.

• Processing initial application and re-credentialing application
• Verifying competence, medical and professional education, residency, internships, fellowships, additional formal training. Relevant board certification, healthcare affiliations work history, professional references, licensure and certification, DEA certificates, malpractice coverage and privileges the applicant is requesting
• Querying the National Practitioner Data Bank as appropriate
• Querying OIG reports and SAM reports
• Maintaining the credentialing database assuring accuracy and completeness
• Organizing and maintaining credentials files
• Facilitating medical staff committee meeting as requested, which includes committee notification drafting agendas and drafting minutes, and any follow up as required
• Maintains knowledge of standards of the Joint Committee on Accreditation of Healthcare Organizations, National Committee on Quality Assurance, and State Federal regulations related to Medical Staff Organization.
• Data Entry
• ICE Audit Score 100%
• File Documents
• Scanning
• Storing documents
• Answer all telephones calls from prospective customers in courteous and professional manner.
• Documents all calls in service log.
• Generate expedited, denial and approval letters.
• Assist answering questions regarding claims
• Check tracers

Title: Credentialing Coordinator