Experience

QueensCare Health Centers

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Referrals Coordinator

  • Nov 2016 - Present



abeo (Abeo Management Corporation)

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Credentialing Specialist

  • Aug 2012 - Nov 2016

  • Prepare and mail credentialing packets to new and established providers. • Process applications for provider & group enrollment (Cal-Optima, Blue Shield, Blue Cross, Medicare, Medi-Cal, United Healthcare, U.S. Department of Labor, Out-of-State Medicaid, TriCare, Cen-Cal). • Timely communication with payers for status updates on provider & group enrollment. • Verify with providers that credentialing packets and payer signature pages were received. • Maintain, assemble and scan… Show more • Prepare and mail credentialing packets to new and established providers. • Process applications for provider & group enrollment (Cal-Optima, Blue Shield, Blue Cross, Medicare, Medi-Cal, United Healthcare, U.S. Department of Labor, Out-of-State Medicaid, TriCare, Cen-Cal). • Timely communication with payers for status updates on provider & group enrollment. • Verify with providers that credentialing packets and payer signature pages were received. • Maintain, assemble and scan credential files for providers. • Prepare written documentation of all verifications. • Ensure timely completion of an application for external providers regarding the eligibility and credentialing decisions and/or related provider issues. • Perform primary source verification for initial and re-credentialing of assigned providers. • Perform data entry & image indexing for new providers. • Establishing new groups/solo/solo Inc. with payers. • Assist with initial appointment & re-appointment applications for providers. • Facility Credentialing for clients who request credentialing with surgery centers or hospitals (Familiar with CPPA Applications). Show less • Prepare and mail credentialing packets to new and established providers. • Process applications for provider & group enrollment (Cal-Optima, Blue Shield, Blue Cross, Medicare, Medi-Cal, United Healthcare, U.S. Department of Labor, Out-of-State Medicaid, TriCare, Cen-Cal). • Timely communication with payers for status updates on provider & group enrollment. • Verify with providers that credentialing packets and payer signature pages were received. • Maintain, assemble and scan… Show more • Prepare and mail credentialing packets to new and established providers. • Process applications for provider & group enrollment (Cal-Optima, Blue Shield, Blue Cross, Medicare, Medi-Cal, United Healthcare, U.S. Department of Labor, Out-of-State Medicaid, TriCare, Cen-Cal). • Timely communication with payers for status updates on provider & group enrollment. • Verify with providers that credentialing packets and payer signature pages were received. • Maintain, assemble and scan credential files for providers. • Prepare written documentation of all verifications. • Ensure timely completion of an application for external providers regarding the eligibility and credentialing decisions and/or related provider issues. • Perform primary source verification for initial and re-credentialing of assigned providers. • Perform data entry & image indexing for new providers. • Establishing new groups/solo/solo Inc. with payers. • Assist with initial appointment & re-appointment applications for providers. • Facility Credentialing for clients who request credentialing with surgery centers or hospitals (Familiar with CPPA Applications). Show less



DS WATERS OF AMERICA

• Customer Service Rep

  • Aug 2005 - Dec 2009