●Prepare quarterly reports for new provider and reappointment applications for Leadership team● Complete and maintain revalidation requests and re-credentialing applications.● Maintain internal provider grid to promote accurate information.● Coordinate with revenue cycle teams and billing team.● Review provider documentation to promote compliance with quality and regulatory standards.● Develop and implement credentialing process improvements and prepare reports.● Update and maintain provider database documents and profiles.● Analyze and resolve information discrepancies, idiosyncrasies and gaps.● Develop and implement improved system controls, preventing reoccurrence of provider complianceissues.● Warn holders of identified infractions and penalties to prevent further violations.● Complete detailed reports showing evidence of compliance issues and recommendations for correctiveactions.● Manage correspondence between medical applicants and company decision-makers to determineeligibility status.● Prepared and provided reports for internal and external providers as appropriate.

I am responsible for the timely and accurate maintenance of information in the credentialing databases and resolution of system edits, and working with providers and clients to ensure the timely process of adding our providers to be able to see patients for our clients. I also help facilitate state licensing, DEA registration, and liability insurance applications/renewals for providers; and assurance of timely completion of reappointment/re-credentialing forms.

Helped process provider applications and re-applications including initial mailing, review and loading into the database trackingsystemConducted audits and provide feedback to reduce errors and improve processes and performanceAssisting providers and credentialing contacts at provider groups in ensuring applications were correctly filled in, answeringquestions/concerns, and finding the appropriate person if I am unable to fulfill needs of the provider for their questions orconcernsWorking with compliance workflows and processes, including NCQA policies and practicesResearching and applying government regulatory informationProcessing providers within multiple states regulatory information and specific requirements

Assist doctors in choosing individual patients based upon the referral and intake paperwork, Schedule new and return neuropsychological and autism evaluations for our group of doctors. Manage and updated weekly/monthly team calendars to facilitate postdoctoral scheduling ofpatients on each individual doctor’s clinic days. Work directly with doctor's to resolve scheduling of special requests and patient add-ons. Gather additional information from outside clinic’s, school districts, social workers and attorneys. Act as liaison between other specialties within UMPhysicians to coordinate evaluations for out ofstate/country patients who need to see multiple providers in a short amount of time (Oncology,hematology, pre-transplant workups and yearly re-evaluations). Review and process incoming paperwork from parents, schools, doctors, etc. for evaluations andgive brief overview to each doctor and their supervising doctor for each patient. Create and maintain management level dashboards and activity tracking reports. Maintain daily tracking log showing each patient contact, what action was completed/outcome toensure accountability. Explain the process and the tests involved to parents, referring doctors, social workers and court personnel

Coordinated complex patient appointments from hospital discharges and follow ups. Registration and scheduling of new and return patients to one or more of the 34 separatepediatric specialty clinics. Administrative back up for pediatric rheumatology; scheduling new patients and contact for doctors.Managed clinic internal message pools and the hospital's discharges for scheduling and contacting patients’ families. Reached out to patients and their families while in clinic for scheduling needs and coordination. Resolve patient and provider complications and find solutions. Complete daily work queues for pediatric clinics

Providing on site first aid services to various sporting events as well as supporting the tournaments and season games as requested by the facility and clients.

Providing consultation over the phone and with on-line chat assisting policy holders with their long term care insurance policies. Answering questions regarding individual/group policies, benefits, billing, and buying long term care insurance. A important part of the job is researching and following up with customers for their inquiries into the policies in a timely manner. Created national database of assisted living and nursing home vendors, including cost of services provided, financial performance metrics and quality of service. Created tracking systems and Excel spreadsheets to reduce returned mail volume and report remediation activities and metrics to clients management teams. Created Claims Intake Form to improve accuracy and claims turnaround times. Redesigned forms making them user friendly and developed training materials to improve training effectiveness and efficiencies. Created new adjusted binding rate quotes for the Policy Owner Services team. Made modifications as requested by legal, tracked the documents and maintained files both electronically and hard copy.

Providing first aid and Emergency transport care for University of MN spectators, players, and employees at various events for the University. As a Lead EMT managed and coordinated the team members for events and maintaining direct contact with UM Police Dept. and HCMC (Hennepin County Medical Center) dispatch.

Contacted contracted employees on a weekly basis to resolve payroll and benefit issues as well as maintaining the companies employee and client databases. Managed the payroll process by inputting the time from employees and contractors time sheets, entering commission data and processing the payroll through the ADP system. Reorganized and maintained the filing systems for clients and employers.