As a dedicated Credentialing Specialist with over five years of experience in the healthcare industry, I have honed my expertise in credentialing and enrollment for medical, behavioral, and dental providers. My journey has taken me through various roles where I have consistently demonstrated my ability to manage complex credentialing processes, ensure compliance, and support healthcare providers across multiple states.In my current role as a Credentialing Specialist at Medloop, I manage individual provider files, ensuring the accuracy and availability of all critical information. I specialize in credentialing and enrollment for Medicare and Medicaid providers in NY, and NJ. My responsibilities include primary source verification, updating CAQH database files, and completing re-credentialing applications. I also create and manage provider portals and handle ERA, EFT, and EDI enrollments.Previously, as a Credentialing Executive at HQ Analytics, I developed a robust skill set in maintaining provider files and completing credentialing applications. My role involved working closely with various insurance portals and ensuring timely updates to provider information. I successfully managed re-credentialing processes and supported the renewal of state licenses and DEA certificates.At P3 Healthcare Solutions, I gained foundational knowledge in credentialing and enrollment. I learned to take strong follow-ups with insurance companies, complete address update forms, and link providers with organizational tax IDs. This role laid the groundwork for my understanding of credentialing entities such as Type 1 and Type 2 NPIs and licenses.My strengths include meticulous attention to detail, strong organizational skills, and a deep understanding of the healthcare credentialing landscape. I am passionate about ensuring that healthcare providers are properly credentialed and enrolled, allowing them to focus on delivering quality care to their patients.
