Resume

Sign in

Credentialing Coordinator

Location:
Saint Petersburg, FL
Salary:
40,000 - 50,000
Posted:
October 13, 2018

Contact this candidate

Resume:

Teishalyn Erkard-Intravichit

Credentialing Coordinator

**** **** ****** *

St. Petersburg, FL 33702

727-***-****

ac7dgf@r.postjobfree.com

SKILLS

Experience in Credentialing Coordinator/Provider Enrollment, Regulatory and Commercial. Knowledge of CAQH, NPI, Commercial Health Plans, Medicaid and Medicare.

EXPERIENCE

Davita Medical Group, St. Petersburg, FL - Credentialing Coordinator March 2017 - PRESENT

● Managed the completion and submission of provider enrollment applications for all insurance types through the Council for Affordable Quality Healthcare

(CAQH)database and/or paper application Coordinated and performed follow-up with insurance payers via phone, email, fax or website to resolve provider enrollment issues and ensure timely revalidations

● Processed and maintained CAQH enrollments and re-attestations

● Coordinated communication to internal departments of provider start dates, welcome letters and appropriate provider ID numbers as needed

● Maintained documentation and reporting related to completed provider enrollments, provider enrollments in process and revalidation timelines/processes

● Worked closely with hospital and executive leadership, and appropriate hospital staff to expedite completion of forms and requirements including obtaining signatures

● Prepared and initiated ARNP Protocols for existing and new providers

● Input/Maintained Database of Centers and Providers (SyMed - Echo OneApp)

● Mapped and Tracked Electronic Documentation (SyMed - Echo One App) Shriners Hospitals for Children (Contract), Tampa, FL - Credentialing Specialist

February 2015 - March 2017

Managed the completion and submission of provider enrollment applications for all insurance types through the Council for Affordable Quality Healthcare

(CAQH)database and/or paper application Coordinated and performed follow-up with insurance payers via phone, email, fax or website to resolve provider enrollment issues and ensure timely revalidations

• Processed and maintained CAQH enrollments and re-attestations

• Coordinated communication to internal departments of provider start dates, welcome letters and appropriate provider ID numbers as needed

• Worked closely with the external provider enrollment departments

(insurance based) to understand specific application/ enrollment requirements including prerequisites, forms required, form completion requirements, timelines, supporting documentation, and regulations

• Maintained documentation and reporting related to completed provider enrollments, provider enrollments in process and revalidation timelines/processes

• Assisted with managed care delegated credentialing audits; conducts internal file audits

• Maintained appropriate provider enrollment information in the provider regulatory credentialing repository (MD Staff), optimizing efficiency, and performs queries, reporting and document generation as needed

• Worked closely with hospital and executive leadership, and appropriate hospital staff to expedite completion of forms and requirements including obtaining signatures, locating required documentation, etc

• Established and maintained close working relationships with hospital credentialing coordinators, network management, providers and other hospitals/headquarter departments as appropriate and payer contacts Achieva Credit Union (Contract) Sales Support, Clearwater, FL - Administrative Asst.

December 2014 - January 2015

● Compiled and disseminated updated TPI and Escrow information to current mortgage account holders.

● Update database information on current account holders regarding payoffs, escrow totals, TPI, etc.

● Direct correspondence to insurance entities to receive/edit renewals for homeowners insurance information

Verifone (Contract) Sales Support, Clearwater, FL - Support Rep I

● Enter/Validate/Update all incoming purchase orders through RBU work box

● Prepare PO by validating pricing/part numbers. Verifying ship to client information

● Prepare/Send all Order Acknowledgements and Confirmations for each order as completed

● Work with Supply Chain to improve ship dates and move rush orders out keeping customer satisfaction consistent

● Manage RBU Order box to move orders out to SSR's to complete within 72hrs of receiving

● Handle incoming client phone calls regarding placed order/hardware and software inquiries.

● Also assist clients to complete ASM/HelpDesk Annual renewals Emcare (Contract), Clearwater, FL -Credentialing Coordinator

● Entered/Validated/Updated credentialing information for HCA

● Hospital ER Primary and Midlevel Practitioners

● Prepare correspondence (monthly) to providers to update ACLS, BCLS, NPDB, CPR and

● PALS/ALS/ BLS as they came due for renewal

● Updated hard files with new information as cross credentialing, credentialing, licensing and terms take place

● Send requested file information to affiliate branches when cross credentialing is to occur

● Kept Excel spreadsheet of Terminated Providers up to date.

● Close file and prepare for shipment to storage per organizational regulations

● Keep daily mail/FedEx moving to credentialers and sent out throughout the day

EDUCATION

SNHU, New Hampshire (Online) - Health Information Management Fall 2018

Certifications

Florida Notary Public

March 2016 - March 2020



Contact this candidate