Carrie R. Email & Phone Number

Bentonville, Ar, Us

Bentonville, Ar, Us

United States

United States

•Ensured compliance with National Committee for Quality Assurance (NCQA) standards throughout the credentialing process.•Completed CAQH for providers, ensuring accurate and up-to-date credentialing information.•Conducted thorough background checks utilizing the National Practitioner Data Bank (NPDB) and state licensing boards to verify credentials and ensure adherence to regulatory requirements.•Developed audit protocols and criteria to evaluate the accuracy and completeness of credentialing processes•Conducted thorough investigations into adverse information, gathering relevant data and documentation.•Re-credentialing of providers every 2 years.•Prepared medical and dental meeting agendas and distributed relevant documentation to committee members in advance.

●Prepared daily and monthly reports to track accounts receivables, analyze trends and identify area of opportunity. ●Held daily huddles and monthly staff meetings to align team members and communicate priorities. ● Monitored audit results and worked collaboratively with relevant stakeholders to address deficiencies and implement corrective actions. ●Conducted monthly and annual evaluations to assess employee performance, provider feedback and set goals for professional development. ●Administrative Lead for Pain Specialty Council for all Pain Center Departments across Mercy Ministry.