Experience

Lakeshore Regional Entity

• United States
• Mental Health Care
• 1 - 100 Employee

• Credentialing/Quality Specialist

  • Mar 2016 - Present

  Administrative/Credentialing: Develop and implement organizational and individual provider credentialing in Medicaid-funded behavioral health entity (create process flows, forms, response letters, grievance process, etc.). Complete provider quality site reviews/audits, including reviews of emergency processes, facilities, and personnel/training records. Maintain FastLane documentation software for quality audits—loading and editing templates, completing forms, writing reports, etc. Human Resources: Point of contact for questions about Medicaid requirements for Office of Inspector General checks, criminal background checks, driving record files, TB test records, etc. Randomize lists of employees from organizations being reviewed; create spreadsheet of employee names, dates of hires, and titles to be used at the quality audit. Show less



Spectrum Health

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

• Office Manager, Office Coordinator, Credentialing Coordinator

  • Jan 2013 - Mar 2016

  Administrative/Credentialing: Verify provider credentials for assigned caseloads within large medical group. Submit applications to insurance companies and work with them to ensure setup is accurate and timely. Providers were often recent graduates and/or new to the metropolitan area—assist them with getting licenses, malpractice coverage, setting up NPI and CAQH accounts. Utilized electronic/internet signup for payers whenever possible. Meet with physicians and advanced practice professionals throughout the process, as needed. Executive Assistant: Provide customer service to patients, nurses, and physician offices via home health agency (Visiting Nurse Assoc.). Work with malpractice carrier when there were poor outcomes, complaints, and/or risks. Provide administrative support for 13 providers—ensuring corporate initiatives are implemented, coordinating credentialing, arranging regular business meetings, and similar functions. Coordinate facility issues, i.e. fire extinguisher and generator checks, plumbing and flooding problems, underground sprinkling, etc. Coordinated accounts payable/bookkeeping documents for professional corporation and limited liability corporation while merging private practice (i.e. tax forms, appraisals, closing out receivables, administration and closing of 401k plan). Setup provider patient schedules in Epic (electronic medical record); assist providers with time off, schedule blocks, appointments, meetings and the like. Human Resources: Key participant in onboarding of new provider groups (as mergers took place, primary contact for providers for their credentialing questions--often leading to assisting with other items and interfacing with departments such as HR and training). Team Leader for both clinical and clerical office staff. Write and present performance appraisals. Assist in implementing 2 mergers, including changes of benefits, implementing uniforms, streamlining processes, and transferring medical records. Show less



Wayland Union Schools

• Wayland, MI

• Human Resources Specialist

  • Mar 2007 - Nov 2007

  Administrative/Credentialing: Maintain spreadsheet of Continuing Education Units (CEUs) for teaching staff. Update financial spreadsheet with contractual educational reimbursements. Complete semi-annual Registry of Educational Personnel (REP) to ensure compliance with and support finances from the State of Michigan. Executive Assistant: Provide administrative support to Assistant Superintendent (setup filing systems in paper records as well as online folders). Maintain calendar and schedule appointments. Human Resources: Implement automated Substitute calling program, including creating and training teachers and administrative staff; loading district holidays, hours of operation, employee data. Administer benefits programs –health care, leaves of absence/Family Medical Leave Act unemployment notices/claims. Coordinate annual benefits open enrollment—notifications, materials, meetings, etc. Post job openings, assimilate incoming resume’s, prepare files for hiring supervisors. Run and interpret background checks for all volunteers in the district (ICHAT). Use spreadsheets and mail merge to send written notification of approvals and maintain ongoing list of approved volunteers. Show less



Harlo Corporation

• Grandville, MI

• Human Resources/Executive Assistant

  • Sep 2006 - Mar 2007

  Executive Assistant: Provide administrative services to the executive team at manufacturing company--planning and executing monthly employee birthday/anniversary celebrations, annual holiday breakfast, retirement luncheons, and summer outings. Human Resources: Support human resource processes, including personnel/staffing, workers’ compensation, payroll, safety initiatives, and company-wide training. Administer benefits programs –health care, life, short-term disability, COBRA, leaves of absence/Family Medical Leave Act, and pension plan. Revamp employee files to ensure proper documentation present/unnecessary documents purged. Cleanse and archive employee files, some dating back to the 1960’s. Utilize software to develop new employee handbook and other policies, including random drug testing policy. Arrange pre-employment physicals for incoming candidates. Present overview/orientation to new employees. Assist with labor relations interactions, including terminations. Process annual review/audit of I-9 forms with Director of Human Resources. Show less



Blue Care Network

• Hospitals and Health Care
• 200 - 300 Employee

• Executive Assistant, HR Generalist, Claims Supervisor

  • Nov 1984 - Aug 2006

  Executive Assistant: Provide executive level support to CEO, COO, and other company leaders at Health Maintenance Organization (HMO). Assistant to marketing department--preparing benefit summaries, coordinating meetings, and working with local labor leaders. Receive incoming and place outgoing calls with questions about open enrollment, benefits, etc. Corporate Secretary to non-profit Board of 15 directors, including coordinating annual summer retreat, nominations and elections to Board of Directors, and preparing meeting minutes. Human Resources: Administer annual merit program, utilizing spreadsheet software and past years’ data to determine financial implications; create reports to examine consistency of pay in job title and classification. Design and implement recognition program to include categories for years of service, project completion, and spontaneous opportunities. Prepare annual Affirmative Action plan and supporting management reports. Interview, hire, and onboard staff. Participate in trainings about relevant human resource topics—attendance, contract changes, FMLA, interviewing skills, etc. Write and present performance appraisals. Show less