Credentialing Coordinator,Administrative Assistant, Customer Service

Nicole Battle

*******@*****.***

CELL 832-***-****

A highly motivated individual with a proven track record of providing

top quality work and advancing within an organization. Possesses strong

communication and human relation skills. Proven records of success,

producing high quality work under stressful conditions. An individual

with responsibility and dependability to work independently or within a

team management environment. Resourceful professional with 13 years of

increasingly accountable organizational roles.

PROFESSIONAL Experience

5/2013-2/2014 Baylor College of Medicine

Administrative Assistant (Credentialing)

Performed credentialing activities to ensure the integrity and

quality of practitioner credentialing and practice data.

Conducted thorough background investigations and compiles

profiles for practitioners applying for

appointment/reappointment to Baylor Medcare.

Processed applications and performed data entry timely,

accurately, and in compliance with Baylor Medcare and the

National Committee for Quality Assurance (NCQA) standards.

Performed these and other functions as necessary to meet

departmental goals with only general supervision.

Accurately keyed all new physician/provider data into Cactus

credentialing database

5/2008-4/2013 Universal American Corporation

Credentialing Coordinator

Processed provider credentialing applications in accordance with

accreditation standards, regulatory requirements, and policies

and procedures.

Verified, researched, and responded to telephone and written

inquiries, from providers and other departments pertaining to

provider participation and credentialing status in a

professional and courteous manner.

Examined, entered data files, and gathered all information

necessary to process information received from providers to

support the credentialing process.

Accurately keyed all new physician/provider data into Cactus

credentialing database.

Responsible for primary source verifications/queries for the

National Practitioner Data Bank, OIG, EPLS, and various

specialty boards.

Performed daily trafficking duties such as opening and closing

job tickets in Net Suite.

Maintained all additions, terminations, and changes to all plans

as appropriate.

01/2007- 5/2007 Universal American Corporation (Venturi

Staffing Partners)

Customer Service Representative

Answered 50-100 inbound calls daily.

Verified benefits, claims status, and billing inquiries.

Assisted floor supervisor with escalated issues.

Explained benefits of different insurance plans offered to new

clients.

Authorized inpatient and outpatient admissions as well as lab

procedures.

Verified new application statuses for sales agents.

12/2005-10/2006 New Horizons, CLC (Venturi Staffing Partners)

Front Desk Receptionist

Answered multi-line telephone.

Prepared instructors learning materials for in-house and

off-site classes.

Responsible for administering exams for various clients as well

as maintain testing center.

Checked in all incoming students for 1st day of class.

Assured payment for class or classes was received prior to

actual class date.

Filed sales receipts and invoices for Account Executives on

staff.

Performed various clerical duties as assigned.

1/2005-12/2005 Oncology Consultants

Medical Receptionist/Front Office

Duties include but are not limited to: collecting co-pays,

filing patient charts, and inserting pertinent information into

charts, and greeting patients and family members.

Responsible for answering 10-line telephone by third ring, and

routing calls to physicians as well as RN's on staff.

Responsible for verification of benefits for all new patients,

and also inputting their demographic information into NextGen.

Experienced in explaining patient balances, and setting up

payment arrangements.

3/2003-1/2005 TRS Behavioral Care

Administrative Assistant/ Front Desk Receptionist

Answered multi-line telephone

Inputted patient's demographic information by way of data entry.

Liaison between all impacted departments to ensure proper

communication practices.

Planned and coordinated company luncheons, and developed

presentations for on-site and off-site meetings.

Processed daily, weekly, and monthly spreadsheets to reflect

patient census.

4/2001-2/2003 Girling Healthcare

Administrative Assistant

Answered 15-line telephone, and routed calls to various staff

members

Coordinated weekly schedules for RN's, LVN's, and Medical

Assistants

Verified insurance benefits by cold-calling to various insurance

and Medicare providers.

Inputted patient demographic information by way of data entry.

Organized itinerary and made travel arrangements for Office

Manager.

Worked closely with case managers filing, faxing, and making

copies.

Education

Texas School of Business Major: Administrative Assisting

Graduated in 2002

1/2006-5/2006 Texas Southern University Major: Mass

Communications

Houston Community College Major: Associates in Liberal Arts

Graduated in 2013

8/2013- Present Prairie View A&M University Major: Corporate

Communications

Minor: English

Skills

MS Office, Outlook, Excel, PowerPoint, Data Entry Medical

Terminology, Virtual Credentialer, Cactus, Facets, Net Suite

Contact this candidate