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Team Lead Credentialing Specialist

Location:
Longmont, CO
Posted:
January 24, 2024

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Resume:

Stela B Ejova

Longmont, CO ***** 773-***-**** ad22xh@r.postjobfree.com https://www.linkedin.com/in/stela-ejova Team Lead Credentialing Analyst; Compliance Analyst; Auditor A strong Team and Project Lead. Verify and evaluate qualifications, licenses, and certifications of individuals or organizations, ensuring compliance with standards and regulations. Meticulously review and maintain accurate records, employing attention to detail and analytical skills to uphold quality and integrity in credentialing processes. A keen understanding of industry-specific requirements, strong organizational abilities, and a commitment to upholding professional standards.

Core Skills

Attention to Detail Decision Making Conflict Resolution Compliance & Auditing MS Word & Excel Languages: Fluent Bulgarian & Conversational Spanish Exceptional Customer Service Leading Projects and Teams Claims Follow-Up Billing

Experience

AMN Healthcare, Remote, CO 03/2021 - 11/2023

Team Lead Credentialing Analyst-Travel Nursing; Strike Support Team Lead and Subject Matter Expert to support work stoppage projects and trained and mentored new internal members. Traveled on-site and credentialed clinicians in a fast-paced environment. Supported team members through one-on-ones for coaching, feedback and growth. Projects participated in: FEMA, Mass Vaccination, HSG work stoppage and Rapid Response, 3rd party credentialing, DocuSign reducing footprint; UAT testing; Completed Emerging Leader Program, ADKAR; 1 of 4 to participate in Joint Commission Audit; Led Quarterly facility Audit; trained overseas members; Selected to participate in numerous audits.

● Collaborated with Clinicians and Recruiters to complete credentialing process in a matter of 2-4 days; ensured Travel clinicians fulfilled hospital and state compliance requirements before start of assignment.

● Performed license and certification verification, reviewing and scheduling medical documentation verification, running background checks, completing I9 forms, facility required paperwork.

● Pivoted quickly to different teams, facilities, projects and responsibilities as the company’s needs changed during and post COVID.

Clinica Family Health Services, Lafayette, CO 06/2015 – 01/2020 Credentialing Specialist/HR Department

Provided Credentialing services for over 200 Providers and 300 Practitioners and worked closely with Recruiting Personnel in on-boarding Providers abiding by all guidelines.

● Revamped Credentialing Process to run more efficiently

● Researched and recommended a new software to streamline the Credentialing / Recredentialing process that was accepted and implemented.

● spearheaded private Insurance enrollment of each Provider in addition to Medicare / Medicaid enrollment.

● Trained full time employees and helped bring all Providers and support staff to ensure BLS/ACLS compliance under new guidelines.

● Submitted New and Re-assignment Hospital Privilege applications for qualified Providers. Stela B Ejova ad22xh@r.postjobfree.com Page Two

● Completed Re-credentialing Process for each Provider every 2 years and submitted to a Board of Directors along with New Provider Files monthly.

● Worked closely with the Billing Department to ensure Providers were enrolled and billable. Alternative Medicine Integration, Highland Park, IL 09/2011 – 07/2014 Credentialing Specialist

Handled highly sensitive information and verified credentials of 900 Chiropractic Providers using multiple sources. Participated in Monthly Committee Meetings and prepared a Monthly Invoice List and conducted data entry. Assisting Providers with the Credentialing Process. Helped with annual audit and special projects. Additional Relevant Experience

Illinois Bone and Joint Institute, Morton Grove, IL Medical Receptionist Superior Ambulance, Elmhurst, IL Collections / Customer Service Professional Development

Medical Billing and Coding Specialist Everest College, Skokie, IL



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