Directs all activities associated with a full agenda of a Credentialing department's day-to-day production regimen. Manages overall staff administration, including Permanent or Temporary employee staffing models, recruiting, performance management, salary administration.  Leading and overseeing the work for collecting and maintaining all data and information to support credentialing providers as well as the payer enrollment process  Ensure departmental goals, quality expectations, and deadlines are met. Requiring intimate knowledge of credentialing industry standards and best practice processes and the ability to guide team members in the direction of compliance. Collaborate with all levels of personnel, providing internal leadership to drive productivity, quality, and the accomplishment of department and company goals Develop, manage and monitor processes and procedures that support the credentialing, re-credentialing, expirables, data management, and delegated credentialing contract processes.  Researched, negotiated, and implemented credentialing online database Oversaw payer enrollment of 100 providers to 46 insurance carriers across 108 insurance plans. Oversees all of the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies Supervises credentialing staff in the day-to-day management of the overall CVO credentialing process and database management. Ensures practice addresses are current with dental plans, agencies, and other entities Preparation of annual group professional liability renewal for providers Audit dental plan directories for current and accurate provider information Maintain strict compliance with State, Federal, and other regulations Oversees provider enrollment of the 21st Century Cures Act registration with the State of New Jersey for participating Providers

Direct support and leadership in establishing quality improvement initiatives. Execute quality checks, analysis, and review of audit findings. Systemize workflow processes for onboarding and credentialing procedures, saving three days on the application process. Key Contributions: Administrative oversight of the online Policy Manual Revise and update 70% of the program's policy manual  Co-Chair the Policies and Procedure Committee Assists in the development of quality initiatives Develop and manage the credentialing process for contracted staff members, volunteer services, student & intern programs, and CDL contracted staff drivers across seven locations throughout the state of NY Develop quality and compliance educational bulletins and newsletters. Managed the credentialing of multiple provider types  Medicare and Medicaid provider enrollment and recertification Recruited, onboarded and trained intern and extern staff Setup, tracked, and maintained all employee fingerprint clearance within the NYS health commerce system Conducts hazardous vulnerability analysis Coordinate and maintain the emergency preparedness program  Co-Chair of the Emergency Preparedness Committee. Assist in the development of Quality and HIPPA training materials. Automation of audit tool library. Administrative oversight of automated Exclusion Checking and tracking of federal files, including OMIG, F-OIG, SAM/EPLS, OFAC, and most individual state files.

Communicated effectively with both internal and external providers as well as departmental leaders. Certified compliance with regulatory agencies by completing internal file audits and corrective actions. Oversaw four direct reports and delegating tasksThe following are highlights of the value I have brought to the company: Bolstered efficiency by 30% through the implementation of credentialing processes.  Successfully re-credentialed the entire medical staff over three months.  Executed initial, reappointment, and verification process for all medical, allied health, and other health professional staff.  Developed and Implemented workflow of credentialing processes expediting 30% more clinical privileges to be processed. Managed four direct reports within the department, delegating tasks accordingly.  Ensured compliance with regulatory agencies by conducted internal file audits and implementing corrective action as needed. Addressed inquiries from multiple healthcare organizations. Communicated with internal and external providers and departmental leaders daily.

During my time with TeleTech, I delivered exemplary customer service to customers calling in for assistance. I processed customer service transactions to include refunds, store credits, and other service issues in accordance with company policy. I effectively resolved customer challenges to include following up to ensure remediation.

While serving as an Executive Assistant, I supported four senior executives in the organization and management of office systems and processes. I coordinated efficient and productive meetings with global attendees, remote location arrangements, and multiple presenters. I regulated complex academic and clinical calendars. I facilitated presentations, documentation, and materials for the Executive Director.The following are highlights of the value I have brought to the company: Instrumental in recruiting new nurses for hospital staff and the development of a nursing database of 44 nurses which saved the company on the need to purchase credentialing and scheduling software.

• Managed Calendar for both the CEO and DON. • Assessed urgency and priorities before accepting or declining appointments and meetings with the CEO and DON.• Preserved policies and procedure manuals and created a digital copy of each manual.• Developed, established, and maintained metrics and monitoring of quality system elements.• Planned and coordinated logistics and materials for board meetings, committee meetings and staff events.• Ordered and distributed office supplies while adhering to a fixed office budget.• Compiled company information and related material and distributed it to candidates.

• Greeted/checked in patients in polite, prompt, helpful manner to ensure customer satisfaction.• Answered and quickly redirected more than 20 calls per hour.• Entered and maintained patient demographics.• Insurance verification, processed co-pays and reconciled balances.• Reviewed all patient and HIPAA Acknowledgment forms for accuracy and completion.• Ordered office supplies and kept organizational upkeep.

Expertly managed all medical records in an electronic system. Organized credentialed files for over 300 medical staff members. Handled the processing of payroll, invoices, and meetings. Key Contribution: Generated $150K in revenue through expert teamwork on the 2007 education bid, which permitted a contract with the State of New York Board of Education.  Reduced HR tasks by 25% by taking over HR responsibilities, including interviews and evaluations.