Credentialing Coordinator
Resume:
Teishalyn Erkard-Intravichit
Credentialing Coordinator
St. Petersburg, FL 33702
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
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