Experience

• 

  Nova Southeastern University

  • United States
  • Higher Education
  • 700 & Above Employee

  • Credentialing Supervisor

    • Feb 2023 - Present

    • Oversee the credentialing process, ensuring that healthcare providers are appropriately enrolled and authorized to provide services in compliance with regulatory standards.• Facilitate the re-credentialing process for existing providers, ensuring timely completion of required documentation and ongoing compliance with credentialing standards. • Conduct regular audits and quality assurance reviews to maintain data integrity and accuracy in credentialing database and systems. • Serve as a liaison between the organization and external credentialing bodies, such as insurance companies, medical boards, and accreditation agencies. • Stay informed about changes in credentialing regulations, standards, and industry best practices, and ensure organizational compliance with these requirements. • Collaborate with leadership to develop and implement strategies for continuous improvement in credentialing operations and customer service. • Provide guidance, support, and training to credentialing staff, providers, and other stakeholders on credentialling requirements, processes, and timelines.

  • Credentialing Specialist

    • Sep 2014 - Mar 2023

    • Assist in completion of provider credentialing applications for participation in various health insurance plans and networks. • Verify and review provider credentialing, including education, training, licensure, certifications, and professional references, to ensure compliance with credentialing requirements as NCQA and CMS guidelines. • Obtain, review, and maintain documentation related to provider credentials, such as licenses, certifications, malpractice insurance, DEA certificates, and other relevant documents. • Maintain confidentiality, integrity, and professionalism in all credentialing activities and interactions with providers, colleagues, and external stakeholders. • Track and monitor the status of credentialing applications and follow up with credentialing agencies and providers to ensure timely completion and resolution of any outstanding issues. • Process and monitor provider credentialing for a multi-Specialty organization who provide services such as Medical, Ancillary services, Dental, Optometry, Behavioral Health, Mental Health, Oral Surgery, and Audiology.

  • Executive Assistant, VP Clinical Operations

    • Aug 2013 - Nov 2018

    • Serve as a liaison between the VP’s office and internal department, external stakeholders, and executive leadership, fostering positive relationships and effective communication.• Managed confidential and sensitive information with discretion and confidentiality, adhering to privacy and security protocols.• Coordinate special projects and initiatives assigned by the VP, working collaboratively with other departments and team members to achieve objectives. • Coordinate internal and external events, conferences, and meetings hosted or attended by the VP, including logistical arrangements and attendee communication. • Anticipate the needs of the VP and proactively identify opportunities to enhance efficiency, productivity, and effectiveness.