Experience

1st Credentialing

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

• Senior Credentialing Coordinator

  • May 2022 - Present

  - Manage new client intake to include needs assessment, data collection, and communication outreach. - Perform initial government enrollment and recredentialing for groups and providers. - Manage the workflow of the team to ensure projects are completed successfully. - Serve as the primary resource for client questions and concerns. - Manage new client intake to include needs assessment, data collection, and communication outreach. - Perform initial government enrollment and recredentialing for groups and providers. - Manage the workflow of the team to ensure projects are completed successfully. - Serve as the primary resource for client questions and concerns.



Keplr Vision

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

• Credentialing Manager

  • Nov 2021 - Apr 2022

   Leads a team of Credentialing Specialists and Coordinators in the day-to-day operations of the department.  Develops policies and procedures to support the timely execution of provider enrollment and re-enrollment processes for government, commercial and private payers.  Manages the collection of practice and provider data for credentialing and verification purposes.  Identifies and resolves complex practice and provider enrollment gaps.  Prepares and distributes reports to increase transparency in the enrollment and credentialing processes.  Perform ongoing, professional, and effective communication as well as a high standard of customer service with all internal and external stakeholders.

• Credentialing Specialist, Region 4

  • Mar 2021 - Oct 2021

   Manage the initial provider enrollment and re-credentialing processes for 100+ region four providers across nine U.S. states.  Verify and enter acquisition intake data for new practices and providers within region four.  Manage the CAQH profiles of all region four providers for data management and attestation purposes. Research claim denials to determine relevance to area of responsibility and manage any necessary corrective actions.  Manage all directory verifications and attestations for region four practices and providers.  Prepare and distribute communication highlighting insurance carrier and state-mandated provider enrollment changes as well as licensure expiry dates.  Work collaboratively with all areas within the revenue management cycle to deliver high-quality service to optometric practices and providers.



Eye Health America

• United States
• Medical Practices
• 1 - 100 Employee

• Credentialing Specialist

  • Apr 2019 - Mar 2021

   Manage the credentialing process for 30+ ophthalmology/optometry providers.  Manage the payer enrollment and reenrollment processes for 35+ medical and/or vision payers.  Manage the initial and renewal processes for the following provider licensure: South Carolina state medical, federal drug (DEA), and state-controlled drug (CDS).  Manage the hospital privileging and reappointment processes for 14 medical providers.  Manage 30 + provider CAQH profiles for data management and attestation purposes.  Manage the initial and renewal processes for the Clinical Laboratory Improvement Amendment (CLIA) waiver for all practice locations.  Manage the provider enrollment process to the organization’s accountable care organization, Prisma Health Upstate Network.  Maintain the timely renewal of select professional memberships to include the American Board of Ophthalmology and American Academy of Ophthalmology.  Research claim denials to determine relevance to area of responsibility and manage any necessary corrective actions.  Prepare and distribute weekly communication highlighting provider credentialing and payer enrollment status changes, along with payer portal access information.



Prisma Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Academic Coordinator

  • Jan 2018 - Mar 2019

   Managed the credentialing and recredentialing processes for 150+ clinical nursing faculty.  Coordinated access to the following systems for 150+ faculty members and 700+ students: EPIC, myClinicalExchange and HealthStream.  Executed clinical affiliation agreements with accredited academic institutions.  Created and facilitated credentialing-related training sessions for academic partners. Coordinated standing meetings with internal and external constituents to ensure faculty and student compliance with organizational standards, along with state and federal accrediting agencies.

• Senior Student Services Coordinator

  • Jan 2017 - Mar 2018

   Managed the credentialing and recredentialing processes for 1,000+ nursing students. Performed student record audits to enhance credentialing compliance.  Coordinated assessment initiatives used to report and enhance departmental processes and programmatic impact.  Reviewed departmental policies and procedures for process optimization.



Clemson University

• United States
• Higher Education
• 700 & Above Employee

• Associate Director, Multicultural Programs

  • Jun 2014 - Jan 2017

   Created, implemented and assessed 50+ university-wide diversity, equity and inclusion (DEI) programs and trainings annually.  Hired, trained, and supervised undergraduate and graduate student-staff members.  Manage all marketing, budgeting and contracting efforts around DEI programming and training.  Served as the faculty advisor to 7+ multicultural student leadership organizations.  Coordinated assessment initiatives used to report and enhance departmental processes and programmatic impact.  Served on various department and university-wide committees to advance DEI initiatives.



James Madison University

• United States
• Higher Education
• 700 & Above Employee

• Assistant Director, Center for Multicultural Student Services

  • Nov 2011 - May 2014

   Managed a campus-wide program that facilitated 30+ DEI programs/trainings in residential communities annually.  Hired, trained, and supervised undergraduate student-staff members.  Created, implemented, and assessed service and experiential-learning trips for students.  Served as the faculty advisor to three multicultural student leadership organizations.  Coordinated assessment initiatives used to report and enhance departmental processes and programmatic impact.  Served on various department and university-wide committees to advance DEI initiatives.



University of Mary Washington

• United States
• Higher Education
• 700 & Above Employee

• Assistant Director, James Farmer Multicultural Center

  • Nov 2005 - Oct 2011

   Created and implemented 20+ university-wide diversity, equity and inclusion (DEI) programs annually.  Hired, trained, and supervised undergraduate student-staff members.  Developed concepts and managed the creative process for all departmental marketing efforts.  Created and implemented 20+ university-wide diversity, equity and inclusion (DEI) programs annually.  Hired, trained, and supervised undergraduate student-staff members.  Developed concepts and managed the creative process for all departmental marketing efforts.