Manager Medical
Resume:
§ Attention to Detail
§ Team Leadership
§ Project Planning
§ Improving Efficiency
§ Self Motivated
§ Committed to client
satisfaction
SKILLS
MEDICAL LICENSE SPECIALIST Boca Raton, FL
SATS Inc./Dr. Stanley S. Zimmelman 10/1/11-Present
§ Initiate and use problem solving techniques in order to expedite the application process with the objective of timely, accurate and legally sufficient preparation for Medical State Licenses, Locums assignments, and Hospital privileging.
§ Execute DEA applications.
§ Update, complete, and submit FCVS or UA application.
§ Process hospital and locums re-credentialing applications.
§ Acquire court documents pertaining to malpractice cases.
§ Assist in completing FBI fingerprinting packets.
§ Monitor and update CAQH profile.
§ Research requirements for obtaining additional certifications.
§ Responsible for enrolling provider into Medicaid and Managed Care Plans for multiple states.
CREDENTIALING SPECIALIST Palm Springs, FL
Health Care District/Healthy Palm Beaches 08/13 – 11/13
§ Processed provider enrollment and credentialing in accordance with accreditation standards, regulatory requirements, policies and procedures.
§ Responsible for primary source verification via NPDB, OIG, and FSMB.
§ Responsible for providing provider resolution to recruitment of network.
§ Investigated and presented DOH claims to Director and Credentialing Committee.
§ Completed dis-enrollment as required.
§ Maintained Provider database.
§ Communicated with Provider Reps to maintain the physician and district relationship.
FRONT DESK TEAM LEADER Lake Worth, FL
Midtown Imaging/GSM Hospital -Tenet 08/10 – 05/11
§ Supervised Front desk and facility staff (13).
§ Assisted Director in preparation and execution of meetings.
§ Collaborated with physician Liaison to maintain good relations with accounts.
§ Implemented flow process for patient registration.
§ Monitored and arranged daily patient and staff schedule.
§ Controlled inventory and ordered facility supplies.
§ Implemented process to avoid errors in billing and HIPPA violations.
§ Applied and obtained facility licenses and permits.
§ Organized and prepared facility for Fire Safety, JCAHO, and Pharmacy inspection.
Cindy Vasquez
acs3gd@r.postjobfree.com
Experience
TECHNICAL
Microsoft Word
Microsoft Excel
Microsoft Power point
STAR
PBAR
Jaguar
SYMED
CREDENTIALING COORDINATOR Lauder Lakes, FL
Pediatric Associates 06/10 - 8/10
§ Coordinated all aspects of credentialing for 143 health care professionals.
§ Prepared files for audits.
§ Coordinated credentialing and re-credentialing applications, conducted document research as well as primary source verification.
§ Interfaced between providers and facility staff to collect required information.
§ Submitted applications to Manager, Medical Director, and Credentialing Committee for review.
§ Enter and maintain all Provider information into credentialing database.
§ Created, maintained, and re-attested CAQH files for providers. CREDENTIALING SPECIALIST Palm Beach, FL
Midtown Imaging 10/09 – 6/10
§ Prepared credentialing and re-credentialing applications for Medicare 855 B and 855 R for 129 physicians.
§ Created physician roster of participating plans to avoid billing errors.
§ Maintained physician database with application status.
§ Verified physician’s licenses and board status through FL-DOH, AMA, OIG, PLCR, and NPDB.
§ Performed ongoing research to correct data to identify duplicate provider, locations, and plan participations.
§ Traveled to physicians’ locations to obtain required documents and signatures to meet required deadlines.
MEDICAL COLLECTIONS SPECIALIST N.Y. N.Y.
Maxims Billing Services 10/05 – 5/07
§ Discovered unpaid claims and collected payment from private insurance and third party payors.
§ Identified error trending, identification and provided to billing dept.
§ Presented accounts that required insurance appeals and follows up accordingly.
§ Researched and resolved account disputes and billing discrepancies.
§ Arranged payment plans with patients.
§ Identified delinquent accounts requiring external collection efforts.
§ Created monthly statements for billing accounts. Cindy Vasquez
EDUCATION Experience continued
ASSOCIATES DEGREE
Healthcare Staff Management
National American University
2008 – 2011
CREDENTIALING SPECIALIST /ASSISTANT MGR. Brooklyn, N.Y. Bay Heights Ob/Gyn 05/98 – 07/06
§ Increased patient volume and revenue.
§ Prepared credentialing as well as re-credentialing applications for managed care plans.
§ Equipped surgery/ examination rooms and assisted on various patient procedures such as Leep-Biopsy, Pesary fitting and routine examinations.
§ Ordered all surgical and office supplies and maintained inventory on medical supplies.
§ Scheduled and coordinated physicians personal appointments, business meetings, and vacations.
§ Maintained reports on and kept abreast of current requirements required at each facility.
§ Assisted in opening and organizing additional location. OFFICE MANAGER Brooklyn, N.Y.
Nu-Tone Fabrications Office Manager 09/07- 04/98
§ Handled all Accounts receivable and payable.
§ Handled Bi-weekly Payroll.
§ Coordinated vacation and staff coverage.
§ Resolved customer issues or concerns.
§ Maintained inventory of main office and shop.
§ Scheduled and coordinated deliveries.
LUTHERAN MEDICAL CENTER Brooklyn, N.Y.
E.R. Patient Service Associate 05/95 – 09/97
§ Processed registration for emergency room visits and ambulatory surgery procedures.
§ Received Paramedic Trauma calls and notified appropriate departments.
§ Transported patients from ER to Labor and Delivery and Radiology department as needed.
§ Maintained patient confidentiality regarding access to patient and other clinical information.
§ Initiated STAT requisitions for procedures and treatment.
§ Organized inpatient and outpatient services.
Cindy Vasquez
Experience continued
REFERENCES
Stanley S. Zimmelman, D.O.
SATS Inc.
Katina Smith
Health Care District
Ty Royal
Good Samaritan Hospital
Dr. George Aglialoro
Bay Heights Ob/Gyn
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