Teona N Briggs C.M.A.A

860-***-****

ad45cz@r.postjobfree.com

Credentialing Specialist

Credentialing Experience Customer Service Driven

Instinctive and ambitious Credentialing Specialist Professional with over 23 years’ experience in customer service roles, administrative duties, and data entry. Outstanding team player recognized for introducing effective methods to increase productivity within the department. Exceptional communicator with strong problem resolution and ability to serve provider/client-needs Areas of Experience

Customer Service

Medical Terminology

License Verification

Effective Time Management

Agendas

Medical Transcription

Data Entry

Initial/Re-credentialing Files

URAC NCQA Audits

Committee Meetings

Interviewing/Training

Epic

Connexall

Cactus Database

Auditing Files

Microsoft Office

Highly Sensitive Documents

Education & Professional Development

CERTIFICATE, TUNXIS COMMUNITY COLLEGE, FARMINGTON, CT, (2019) CERTIFICATE, GREENVILLE TECHNICAL COLLEGE, GREENVILLE, SC, (1993) Professional Experience

Uconn Healthcare(Ciox/Datavant)- Farmington, CT 09/2023 - current Health Information Specialist (ROI)

Understanding of HIPAA requirements for releasing medical records and medical record requests. Handling inbound and outbound calls, email, fax and other administrative tasks. Assisting walk up patients and/or clients. Receive and process requests for patient health information in accordance with Company and Facility policies and procedures. Inform manager of work, site difficulties, and/or fluctuating volumes. Assist with additional work duties or responsibilities as evident or required. Responsible for safeguarding patient records and ensuring compliance with HIPAA standards. Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately. Assist with administrative duties such as handling faxes, opening mail, and data entry. Inform senior leadership of issues, opportunities or challenges. Assist with Quality Assurance tasks as directed by management. Acts in a lead role with staff regarding general questions and other duties as assigned. Uconn Healthcare- Farmington, CT 12/2022 - 7/2023

HUC - Unit Secretary

Responsible for processing new admissions. Greets and receives new patients and visitors. Respond to patient and visitor requests or complaints. Obtains patients’ information, assembles/reviews patients’ charts upon admission. Notifies nursing staff/physicians of patient admission or returns of surgical patients. Communicates with patients’ family members and help them comply with admissions and discharge procedures. Notifies staff of critical diagnostic test results; tile/scan diagnostic test results. Requests services from ancillary and support using EPIC database. Transports specimens, supplies, and medication using pneumatic tubes. Maintain unit records, performs quality assurance on charts, verify they are all labeled, forms filed correctly, and allergies noted. Order supplies for unit and maintain stock of unit materials. Send and receive documents via fax machine, scanners, and email. Utilizes and communicates with staff and patients via Connexall. Answers and process unit phone calls also assists in the orientation of new staff. Attend in-service training sessions and department staff meetings as required. Observes EKG monitors and reports irregularities to appropriate medical staff. Assigned other duties as needed. The Orchards - Hartford Healthcare, Southington, CT 09/2018 - 01/2023 Administrative Assistant

Responsible for greeting all visitors, taking temperatures, and ensuring they are signed in and wearing a face mask. Other duties include taking breakfast, lunch, and dinner requests over the phone for residents. Ensure newspapers are labeled by room number, folded and put in the appropriate mail slot by unit number. Hanging up new activities flyers on the bulletin boards and discarding of any old items prior to shift ending as well as documenting any resident purchases made from the Country Store to be charged to their account at the end of the month or place the cash in the envelope. I also documented employees that ordered/paid for (breakfast, lunch, and dinner) placed the cash in the envelope. Responsible for locking/unlocking entrance doors for patient and employee safety. Completed additional duties as assigned. eviCore Healthcare, Remote, CT 09/2018 - 12/2022

Sr. Credentialing Specialist III

Process Credentialing and Re-Credentialing Applications for Multi-specialty providers’. Responsible for data entering, gathering, and primary source verification of healthcare facility and physician documentation. Comparing the Cactus database to information provided on the application. Research and request additional documentation for discrepancies found. In addition may lend additional support for special projects as needed.

Aerotek (ConnectiCare), Farmington, CT 08/2017- 05/2018 Credentialing Coordinator

Process Re-Credentialing Applications for Multi-specialty providers’ using CAQH and Cactus databases to verify/compare information provided. Research any discrepancies in licensure, malpractice, or NPI. Prepare completed applications for weekly Committee Review. Reach out to provider groups via phone or email to obtain missing information.

Connecticut Children’s Medical Center, Hartford, CT 01/2017- 05/2017 Medical Staff Credentialing Specialist

Process applications to the medical staff in accordance with the hospital specific bylaws and regulatory standards. Prioritize applications in the queue to assure timely processing and approval by leadership groups. Maintain the Medical Staff Credentialing database and interact with external databases. Secure documents for primary source verification. Produce and reply to general correspondence. Prepare files for medical staff leadership review, identifying discrepancies in the application. Notify various departments and units of new providers. Respond to verification inquiries concerning current or previous medical staff members. Interact on a regular basis with applicants, medical staff leadership, regulatory agencies, and healthcare facilities.

HARTFORD HEALTHCARE, Wethersfield, CT 04/2016 – 01/2017 Medical Staff Credentialing Specialist

Process applications to the medical staff in accordance with the hospital specific bylaws and regulatory standards. Prioritize applications in the queue to assure timely processing and approval by leadership groups. Maintain the Medical Staff Credentialing database and interact with external databases. Secure documents for primary source verification. Produce and reply to general correspondence. Prepare files for medical staff leadership review, identifying discrepancies in the application. Notify various departments and units of new providers. Respond to verification inquiries concerning current or previous medical staff members. Interact on a regular basis with applicants, medical staff leadership, regulatory agencies, and healthcare facilities.

EVICORE HEALTHCARE, Plainville, CT 07/2000 - 04/2016 Sr. Credentialing Specialist

Verify Provider Licensure and Malpractice Insurance for a Multispecialty Provider Network. Investigate files with discrepancies using various databases. Assist with committee to assure that all files Initial/Re-credentialing are accurate and complete. Prepare files for URAC and NCQA Federal and State Audits. Timely completion of provider credentialing as outlined in the Credentialing Manual. Certifications

Certified Medical Administrative Assistant (C.M.A.A) HEALTH UNIT COORDINATOR (UNIT SECRETARY)

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