Melanie Davis

Fort Worth, TX

ad1ml2@r.postjobfree.com

+1-214-***-****

I've facilitated Medical Professionals Credentials for Hospitals, Surgery Centers, Licensures, Commercial and Government Payers within multiple States for over 15+ yrs. Authorized to work in the US for any employer

Work Experience

Credentialing Coordinator

Tribal Health - Fort Worth, TX

August 2021 to Present

• Assisted Physicians & Allied Health complete Initial, Reappointment, Temps, Locum Tenens & Additional Privilege, Delineation of Privileges (DOP) & Facility Forms.

• Maintained professional relationships with all Hospital, Surgery Center & Payor contacts.

• Facilitated quick response to all requests; additional documents, explanations, Case Logs, etc.

• Maintained Physician Certified Medical Education (CME) & Allied Health Continued Education Units

(CEU), CPR Certifications (ACLS, BLS, ATLS, etc.).

• Facilitated Peer References Questionnaires

• Maintained Physician & Allied Health Practitioners profile data in credentialing database

• Provided Internal & External Customer Service support by multi line phones, multi email boxes, face to face

Personal

April 2019 to August 2021

Took time to be with my Family and COVID.

Credentials Coordinator

PPG - Fort Worth, TX

August 2018 to April 2019

• Assisted Physicians & Allied Health complete Initial, Reappointment, Temps, Locum Tenens & Additional Privilege for Hospital & Surgery Centers, Applications for Multi States Credentials Application, Delineation of Privileges (DOP) & Facility Forms.

• Assisted Physicians & Allied Health enroll & maintain updates to Council for Quality Healthcare (CAQH), National Provider Identifier (NPI), Drug Enforcement Administration (DEA), Federation State Medical Board (FSMB), Various State Medical Boards (TMB, OSB, CSMB) etc.

• Assisted Physicians & Allied Health Initial, Reappointment, Denials, Updates & EFT for Commercial Payers (BCBS, Cigna, etc.) Medicare (PECOS) & Medicaid within multiple states.

• Maintained professional relationships with all Hospital, Surgery Center & Payor contacts.

• Facilitated quick response to all requests; additional documents, explanations, Case Logs, etc.

• Maintained Physician Certified Medical Education (CME) & Allied Health Continued Education Units

(CEU), CPR Certifications (ACLS, BLS, ATLS, etc.).

• Maintain Physician & Allied Health Practitioner Case Logs from primary Facility(ies) & Multi State Licensure(s)

• Facilitated Peer References Questionnaires

• Maintained Physician & Allied Health Practitioners profile data in credentialing database

• Provided Internal & External Customer Service support by multi line phones, multi email boxes, face to face

Credential Coordinator

GI Anesthesia Associates - Katy, TX

August 2016 to June 2018

• Prescreen; Telephone Interviews, verifications of licensure(s), sanction(s), board(s), references, coordinate interview with Partnering Group, facilitate Contract & onboarding.

• Developed Excel Credentialing Database

• Maintain Physician & Allied Health Practitioners profile data

• Developed GIAA Contractor Application

• Wrote Credentialing & Contractor Departmental Policies & Procedures approved by Board.

• Provided Internal & External Customer Service support by multi line phones, multi email boxes & face to face

• Assist Billing Department with denied claims to determine potential adjustments

• Department Payroll; vacation, sick, jury duty, Holiday & punch corrections.

• Assisted Physicians & Allied Health complete Hospital & Surgery Centers Initial, Reappointment, Temps, Locum Tenens & Additional Privilege with Multi State(s) Credentials Application, Delineation of Privileges

(DOP) & Facility Forms.

• Assisted Physicians & Allied Health enroll & maintain updates to Council for Quality Healthcare (CAQH), National Provider Identifier (NPI), Drug Enforcement Administration Personal

Mansfield, TX

July 2013 to August 2016

My son passed away. Took time to grieve an relocate to Katy, TX. Credentials Coordinator

NorthStar Anesthesia - Arlington, TX

November 2011 to July 2013

• Assisted Physicians & Allied Health complete Initial, Reappointment, Temps, Locum Tenens & Additional Privilege Hospital & Surgery Center Applications for Multi States Credentials Application, Delineation of Privileges (DOP) & Facility Forms.

• Assisted Physicians & Allied Health enroll & maintain updates to Council for Quality Healthcare (CAQH), National Provider Identifier (NPI), Drug Enforcement Administration (DEA), Federation State Medical Board (FSMB), Various State Medical Boards (TMB, OSB, CSMB) etc.

• Assisted Physicians & Allied Health Initial, Reappointment, Denials, Updates & EFT for Commercial Payers (BCBS, Cigna, etc.) Medicare (PECOS) & Medicaid within multiple states.

• Maintained professional relationships with all Hospital, Surgery Center & Payor contacts.

• Facilitated quick response to all requests; additional documents, explanations, Case Logs, etc.

• Maintained Physician Certified Medical Education (CME) & Allied Health Continued Education Units

(CEU), CPR Certifications (ACLS, BLS, ATLS, etc.).

• Maintain Physician & Allied Health Practitioner Case Logs from primary Facility(ies) & Multi State Licensure(s)

• Facilitated Peer References Questionnaires

• Maintained Physician & Allied Health Practitioners profile data in credentialing database

• Provided Internal & External Customer Service support by multi line phones, multi email boxes, face to face

Medical Staff Coordinator, Medical Staff Specialist, Quality Services Specialist Medical City Arlington - Arlington, TX

June 2003 to November 2011

• Credential Initial, Reappointment, Temps, Locum Tenens & Additional privilege applications for Physicians & Allied Health Practitioners use of Texas Standardized Credentials Application (TSCA).

• Performed primary sources verifications in accordance to The Joint Commission (TJC) & Centers for Medicare & Medicaid Services (CMS).

• Performed Background, Licensure, Board Orders, Certifications, Sanctions (OIE, OIG) & National Practitioner Data Bank (NPD) verifications

• Maintain Provider data in credentialing database

• Provided Internal & External Customer Service support by multi line phones, multi email boxes & face to face.

• Assist in appropriate applicant file review & approval as dictated by each Service Line; Department Service Chief Committee Member's.

• Prepare Meeting Agenda, Reports & Minutes for monthly Credentials Committee, Medical Executive Committee & Board of Trustees Applicant reviews.

• Facilitation Orientation & Onboarding new Physicians, Allied Health Practitioners & Paramedical with Provider Portal, Badge Access, Policy & Procedures, Bylaws & Facility Tour. Quality Services/Medical Staff Specialist

• Schedule, coordinate, maintain minutes & records for thirty-four (34) Departmental & Committee Hospital Meetings.

• Texas Department of Health (TDH) & The Joint Commission (TJC) Survey Support.

• Hospital Wide Policy Procedure draft & final support

• Facilitate Medical Staff Credentialing Reappointment Applications, 1st, 2nd & 3rd reminders, track certified mail

• Process incoming Hospital Verification requests

• Facilitate Expirables (License, DEA, Malpractice, Board, Certifications, TB & FLU) notices & updates to database

• Facilitates ER Call Schedule for all Specialties

• Maintenance of Physician Dictionary

• Send Initial Applications Packet requests to Applicants

• Facilitate HCIR Credentialing initiative

• Assist VP of Quality Services, Director of Performance Improvement, Director of Risk Management, Manager of Infection Control & Manager of Medical Staff with special projects as assigned. Family Business

Family Business - Mansfield, TX

August 2001 to June 2003

• Family Delivery Service business with the opportunity to be "Stay at Home Mom".

• Recruiting potential Drivers, Helpers, 3rd Man.

• Facilitate Drug Screening, Background checks, Verifications of past employment, References & Lexus Driving History.

• Weekly payroll, claims & mileage reports, Bank deposits & Gas Card reconciliations.

• Terminations; facilitate Final pay, turnover of Truck, gas card

• Annual Company Events, scheduling location, ordering food, hiring servers, bartenders, Dj & security. RR Business Analysis, RR Supervisor, RR Team Lead, RR Sr Rep, RR Rep Southwest Airlines Corp - Dallas, TX

December 1992 to August 2001

Rapid Rewards Marketing Business Analysis

• Responsible for the Data integrity of the Rapid Rewards Database

• Worked closely with programmers on design, testing, implementation, upgrades & training of system.

• Queried data via SQL & provided monthly reporting for billing & communications to partners/vendors; MCI, AMEX, FUSA, Dollar, etc.

• Supported marketing initiatives by analysts

Rapid Rewards Operations Supervisor

• Managed nineteen (19) employees

• Lead Productivity Reviews & Reporting

• Wrote & provided Annual Evaluations based on performance

• Implementation of Training Program

• Payroll, OT, Attendance, Performance Plans

• Interviewed prospective individuals

• Terminated low performers

• Training new representatives

• Produce monthly work schedule

• Processing & transmitting partner data

• Special projects outlined by Vice President.

Rapid Rewards Operations Representative

• Maintain Rapid Rewards Frequent Flyer (RRFF) Membership accounts; address updates, award companion, notate accounts & assign drink coupons

• Research RRFF flight transactions to Issue new & past credits that were not loaded in the system correctly

• Processed new RRFF enrollments applicants; create account number, enter application information in database & investigate fraudulent applications

• Assist with the fulfillment of RRFF new membership, card replacement, drink coupons, companion passes, free travel vouchers.

Education

High school diploma or GED

Skills

• Microsoft Excel

• Microsoft Word

• Adobe Acrobat

• Customer service

Awards

Employee of the Year

Awarded Employee of the Year by my Peers, Medical Staff & Leadership for my Performance, Customer Service and Attendance.

Star Employee of the Quarter

Awarded Employee of the Quarter for always helping my Team, positive attitude and attendance. Walked a Mile in Someone’s Shoe

Awarded the Walk A Mile in Someone Else’s Shoes for volunteering my time to help other Departments in need.

Fly High Leadership

Awarded Fly High Leader from my Team and Executive Team for my outstanding leadership.

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