Administrative Assistant Manager
Resume:
LISABETH TAMZRIAN
Brooklyn, New York 11214
*********@*********.***
PROFILE
• A challenge-oriented professional with experience in the coordination and maintenance of operational standards.
• A problem solver who focuses on the overall picture to ascertain needs and goals, identify difficulties, and formulate solutions that convert negative situations into positive outcomes with a demonstrated record of success.
• A dynamic team player who communicates effectively and performs well under time pressure and high demand.
• Proficient in computerized systems and software (Excel, Access, PowerPoint, Word WordPerfect, Medical Staff Line Software Application, SAM Credentialing Software-(formerly PIPF), Luci Credentialing Software, Quickbase, AC Database, Share Point, as well as Patriot
• Typing Speed 65+
PROFESSIONAL EXPERIENCE
Amida Care- New York, New York
Credentialing Manager 03/14-06/02/2015
• Oversee the Credentialing Department
• Departmental Time Keeper
• License verifications online
• CAQH
• Credentialing and Recredentialing of providers
• Coordinates the termination process of any delegate who fails to maintain the delegation requirements set forth by Health Plan to credential and re-credential in compliance according policies and regulatory requirements.
• Delegation Oversight Audits
• Entering credentialing notes into database
• Oversee incoming and outgoing Physician, Hospital, Ancillary and Facility contracts and applications
• Oversees the process of accurate and timely information into provider data systems
• Maintains ongoing oversight of all Policies and Procedures to ensure that they are accurate, realistic, and revised as necessary.
• Desktop Policies and Workflows
• Maintains relationships with delegate, delegate's office personnel, and others in obtaining documentation pertinent to timely and accurate completion of the delegated credentialing process.
• Tracks the progress of working files to ensure submission to Credentialing Committee in a timely manner and coordinates the transfer of files ready for Committee review by the Health Plan in a timely basis.
• QA all credentialing files prior to submission of Credentialing Committee Meetings
• Provides process oversight of daily business operations of the credentialing and re-credentialing program to ensure all efforts are made to keep program in compliance according to standards and regulatory requirements
• Works closely with Compliance Department regarding auditing of our provider files
• Works closely with Provider Files Operations Department
• Oversees provider data management systems regarding delegated credential and direct credentialing data loads as well as changes to existing practitioners or provider terminations/dismissals
• Database maintenance to ensure all provider information is accurate
• Attends Credentialing Committee Meetings/meeting minutes
• Major mailings to providers
• Phone, mail, and facsimile correspondence
• May lead special projects
• Maintaining accurate filing system
• Training staff
• In-house training sessions through Reliance Training Program
• Meetings with my superiors/staff
Caduceus Inc. - Jersey City, New Jersey
Manager of Credentialing, 12/10-03/14
• Oversee the Credentialing Department
• CAQH updates for Providers
• Credentialing of Providers into various health plans
• Re-credentialing of Providers for various health plans
• License verifications online
• Works independently with internal and external customers to research and resolve credentialing related issues.
• Departmental Time Keeper
• Phone, mail and facsimile correspondence
• Job interviews and training of new staff
• Entering credentialing notes into Quickbase
• Provide Updates to Clients
• Conference calls with Clients
Atlantis Health Plan- New York, New York
Director of Credentialing, 12/08-04/10
• Oversee the Credentialing Department (4 Staff Members)
• Oversee Provider Relations Staff
• CAQH for Re-credentialing 10/09-04/10
• Aperture for Re-credentialing 09/04-06/09
• Oversee incoming and outgoing Physician, Hospital, Ancillary and Facility contracts and applications
• Manages provider and delegated provider credentialing and re-credentialing process to meet time-sensitive deliverables, including follow-up to providers and other staff directly involved in oversight.
• Provides process oversight of daily business operations of the credentialing and re-credentialing program to ensure all efforts are made to keep program in compliance according to standards and regulatory requirements.
• Tracks the progress of working files to ensure submission to Credentialing Committee in a timely manner and coordinates the transfer of files ready for Committee review by the Health Plan in a timely basis.
• Works independently with internal and external customers to research and resolve credentialing related issues.
• Maintains relationships with delegate, delegate's office personnel, and others in obtaining documentation pertinent to timely and accurate completion of the delegated credentialing process.
• Coordinates annual delegation assessment and onsite visit, on-going monitoring, audit preparation, and credentialing committee preparation and reporting.
• Maintains data files of delegated entities information, including audit results, narratives, credentialing committee notification, corrective action plans and any pertinent documents gathered in the ongoing monitoring process.
• Oversees provider data management systems regarding delegated credential and direct credentialing data loads as well as changes to existing practitioners or provider terminations/dismissals.
• Oversees the process of accurate and timely information into provider data systems
• Coordinates the termination process of any delegate who fails to maintain the delegation requirements set forth by Health Plan to credential and recredential in compliance according policies and regulatory requirements.
• Oversees all licensing and sanction organizations and then shares such findings with Atlantis senior management.
• Supports Atlantis senior management in preparation of annual state audits and ensures the submission of review materials as requested as well as the successful submission and monitoring of corrective action plans.
• Maintains ongoing oversight of all Policies and Procedures to ensure that they are accurate, realistic, and revised as necessary.
• Identifies and works to acquire basic and ad hoc reports of providers, credentialing and re-credentialing programs as be required or requested by Atlantis management.
• Conducts credentialing training for new staff, and refresher training for existing staff. Provides input for training materials and job aids.
• Works closely with Claims, Regulatory, Sales, Customer Services and I.T. departments.
• May lead special projects.
• Office Fire Warden throughout my years at AHP
• See my other positions below for all of the same duties throughout AHP Credentialing Manager, 7/04-12/08
• Oversee the Credentialing Department (4 Staff Members)
• Oversee Provider Relations Staff (varied)
• Oversee Site Visits (2 Staff Members)
Credentialing Supervisor, 5/04-7/04
• Oversee the Credentialing Department and Acting Manager of Provider Relations Dept. (15 Staff Members)
• Organizes work flow of both departments as well as interdepartmental workflow
• Coordinates Provider Representative Field work and Recruiting efforts
• Personally recruits Hospitals, Ancillary Facilities, Medical Groups, and Physicians
• Oversee incoming and outgoing Physician, Hospital, Ancillary and Facility contracts and applications
• Organizes Delegated Credentialing
• Aperture Re-credentialing
• Oversee Staff Performance Work Sheets and Inventory
• Performs Site Visits and Audits
• Job Interviews and Training
• Participates in Monthly Credentialing Committee Meeting and Minutes
• Participates in bi-weekly Management Meetings
• Participates in quarterly QI Meetings
• Participates in bi-weekly Management QI Meetings
• Phone, mail and facsimile correspondence
• Run Crystal Reports for participating entities
• Trains other departmental staff members how to use our credentialing program
• Departmental timekeeper
LUTHERAN MEDICAL CENTER - Brooklyn, New York, 5/94-5/2004 A 500-bed community hospital.
Enrollment Specialist, Managed Care 1/02-5/04
• Oversee the enrollment of Five Physician Groups (134 doctors applying to 34 plans each)
• Fill out Applications for Physicians
• Keep detailed records for each physician
• Keep provider credentialing packages up-to-date
• Phone, e-mail, and mail correspondence
• Coordinates meetings
• Takes meeting minutes
• Run reports
• Filing, Faxing, Supplies
LMC Physician Services, P.C.-(L.M.C.) Brooklyn, New York (6/1999-12/2002) Credentialing Coordinator
• Handled Six Physician Groups (85 doctors applying to 35 plans each)
• Filled out Applications for Physicians
• Kept detailed records for each physician
• Kept credentialing packages up-to-date
• Phone and mail correspondence
• Filing
• Faxing
Client Services Representative/Information Technology Help Desk L.M.C (11/00-1/02)
• Interacts with all areas/departments of the hospital over the phone and occasionally in person
• Enters computer problems from phone calls into Help star program so IT Techs can solve the existing problem
• May assist with troubleshooting problems that I am familiar with
• Writes check requests for supplies purchased from vendors Administrative Assistant to the CIO and Director of Information Services (L.M.C.) (6/98-11/00)
• Interacts with Senior Executives as well as clients and patients.
• Coordinates seminars, meeting and travel arrangements.
• Manages calendars, written correspondence and telephone communication.
• Prepares slides for presentations, expense reports, meeting minutes, check requests, and purchase orders.
• Provides operational support to ensure smooth functioning of office, including filing and ordering of supplies.
• Office Fire Warden for the Executive Suite
Administrative Assistant/Faculty Practice Management (L.M.C.) (5/94-6/98)
• Interacted with Senior Management, physicians, and patients.
• Enrollment of Physicians into Managed Care Plans.
• Responsible for logging physician charges, correspondence with Billing vendor, check requests, and bank transfers.
• Coordinated meetings, seminars, and conferences.
• Coding of Pathology Reports
• Provided support to the Director of Practice Management through typing, filing, faxing, copying, and coding.
• Office Fire Warden for the Executive Suite
EDUCATION
KINGSBOROUGH COMMUNITY COLLEGE - Brooklyn, New York
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