Experience

Bethany Medical

• United States
• Medical Practices
• 100 - 200 Employee

• Credentialing/ Contract specialist

  • Nov 2021 - Present



EmergeOrtho

• United States
• Medical Practices
• 400 - 500 Employee

• Credentialing specialist; Administrative Assistant

  • Jun 2017 - Present



Cheshire Center

• United States
• Individual and Family Services
• 1 - 100 Employee

• Credentialing Specialist/Recruiting assistant

  • Feb 2007 - Jun 2017

  • Publicize openings by posting them in appropriate outlets and work toward developing a pool of qualified individuals. • Coordination of graduate student internships and Clinical Fellowships • Interaction with NCBOE regarding Clinical Fellowship years (i.e. submitting necessary forms and follow-up to see that all SEY/CF paperwork is placed in employee files) • Extending and negotiating offers of employment • Conducting background and professional reference checks Analyze practitioner and facility credentialing applications to determine eligibility status as defined in UCare's Credentialing Plan. Assist in development and implementation of credentialing policies and procedures. Perform primary source verification for initial and recredentialing of assigned providers utilizing NCQA Standards and other federal and state regulatory requirements. Ensure timely verification to prevent any negative impact related to compliance or regulatory requirements. Maintain timely communication with external providers regarding the eligibility and credentialing decisions and/or related provider issues. Serve as resource specialist for internal departments for daily issues related to provider credentialing actitivites. Collaborate with CEO, as necessary, regarding credentialing and re credentialing applications that require additional investigation due to concerns related to professional criteria. Enter and maintain credentialing data following NCQA as well as state and federal requirements. - Coordinates and manages screenings for school settings and daycares. -Sales Calls and P/R when needed. -Worked in Billing for the first 4 years. Show less