Contract/Credentialing Analyst - ASR Coordinator -Medical Staff Coordinator- Credentialing Coordinator HR Assistant

Over 30 years of experience in healthcare and healthcare related positions.

Exceptional capacity to multi-task and manage numerous projects.

Organized and detail-oriented with superior ability to perform a multitude of tasks.

Talent for analyzing problems, developing and simplifying procedures and finding innovative solutions.

Widely recognized as a quick learner and excellent team player who excels in any position or project.

Proven ability to motivate and work effectively with all types of people.

Proactive – always looking to make a positive contribution to the company/organization.

Managed Staff at Porter Hospital.

Professional Experience

Geminus Corporation / Regional mental health– Merrillville, IN July 2010- Present

Promoted to Credentialing/Contract Analyst – Oct. 2018 from

ASR Coordinator

Credentialing physicians and clinicians.

Continually monitoring the addition of clinicians to the paneling of the insurance list and sending

Monitoring the units used and communicating with the clinicians regarding their use of units and the need for a system update or prior authorizations.

Submitting information through Darmha in order for the clients to receive a Medicaid package.

Set up the Campagna process and continue to monitor the admissions, discharges and transfers for the Regional therapists.

Verifying Medicaid Eligibility for the clients upon admission.

Keeping track for Treatment plans and Master Treatment Plans.

Correspondence with physicians that refer.

Training new clinicians on the prior authorization process and system update process.

Maintaining Spreadsheets

Submitting information to insurance companies to get the physicians paneled.

Working with staff and payors to reach solutions to process problems

Porter Hospital – Valparaiso, IN January 2008 – November 2009

Medical Staff Coordinator

Administered the Medical Staff credentialing and reappointment process, and assisted the Medical Staff in supporting the organization’s mission, vision, and goals. Supervised employees in the Medical Staff Office to ensure all processes were followed and timely according the JCAHO standards.

Followed the credentialing process and reappointment process as required by the JCAHO.

Coordinate procurement of DEA, licensure, and malpractice insurance information.

Originate, collect and maintain appropriate records.

Orient Medical Staff leadership to key policies related to their roles.

Maintain documentation of continuing Medical Staff education.

Originate and maintain agenda, meeting minutes, and post-meeting correspondence for all Medical Staff committees.

Prepare credentialing reports and action items for the Board of Directors.

Compose and disseminate correspondence from the Board of Directors to the Medical Staff insofar as decisions related to credentialing, privileges, and special requests.

Develop and implement systems which allow for the flow of information to and from Medical Staff committees into the performance improvement structure.

Maintain and generate performance related data for Medical Staff members and functions.

Orient applicants to the medical staff bylaws, key policies, Medical Staff structure, and performance improvement process.

Stay abreast of and apply knowledge of applicable federal and state laws and regulations and accreditations standards.

Weekly meetings with staff to discuss issues in the office and to streamline processes for better effectiveness.

Approved payroll and pto time.

Planned and implemented Medical Staff functions for the Physicians, Allied Health and their spouses and partners including the Chief Officers and Board members of the Hospital.

Pinnacle Hospital – Merrillville, IN January 2007 – January 2008

Credentialing Coordinator

Responsible for coordination and oversight of the Medical Staff Services Department, including Physician and Allied Health credentialing and re-credentialing, meeting management, flow of information from Medical Staff Committees through the Medical Executive Committee and the Governing Board.

Assist with JCAHO Survey preparation for the Medical Staff/leadership function, including staff and Medical Staff education regarding accreditation standards.

Work closely with Medical Staff leaders, hospital administration, and legal counsel with regard to Medical Staff Rules and Regulations and Bylaws Issues.

Maintain open communication with the Medical Staff, Administration, hospital departments, practitioner’s office staff, and related health agencies. Identify and work to solve problems as they arise.

Maintain knowledge of standards of the Joint Commission on Accreditation of Healthcare Organizations, National Committee on Quality Assurance, and State and Federal regulations related to Medical Staff organization.

Maintain working knowledge of the Medical Staff Bylaws, Rules and Regulations, and hospital policies, and works to ensure the medical staff’s compliance with the stated parameters.

Oversee the processing of all Medical Staff and Allied Health Staff credentialing and re-credentialing applications in accordance with Medical Staff Bylaws, Rules and Regulations, JCAHO standards, and State and Federal law.

Assists the Credentials Committee with development of privilege criteria, privilege delineations, and other documents necessary to an effective credentialing process.

Provide oversight, education, and training, to Medical Staff Services Department staff members.

Provide supportive services to Medical Staff leaders in fulfilling the responsibilities of their offices. Participate with same in developing policies for the Medical Staff, and in monitoring the continuity of Medical Staff activities.

Attend Medical Staff meetings as necessary. Assist as needed with agenda and materials preparation, and record minutes at specified committees.

Maintain confidential credentials files and electronic Medical Staff database.

Exhibit a high degree of responsibility for confidential matters.

Oversee the development of departmental policies and procedures.

Assume other related responsibilities as required.

Community Healthcare System

2002 – 2007

Medical Staff Coordinator/Executive Assistant

Responsible for providing executive administrative support to the Medical Staff Director. Establish, maintain and follow organization and administrative departmental procedures. Rely on experience and judgment to plan and accomplish goals. Perform a variety of complicated tasks, and assist the medical staff in supporting the organization’s mission, vision, and goals.

Administered the Medical Staff credentialing and reappointment process, and assisted the Medical Staff in supporting the organization’s mission, vision, and goals. Supervised employees in the Medical Staff Office to ensure all processes were followed and timely according the JCAHO standards.

Followed the credentialing process and reappointment process as required by the JCAHO.

Coordinate procurement of DEA, licensure, and malpractice insurance information.

Originate, collect and maintain appropriate records.

Orient Medical Staff leadership to key policies related to their roles.

Maintain documentation of continuing Medical Staff education.

Originate and maintain agenda, meeting minutes, and post-meeting correspondence for all Medical Staff committees.

Prepare credentialing reports and action items for the Board of Directors.

Compose and disseminate correspondence from the Board of Directors to the Medical Staff insofar as decisions related to credentialing, privileges, and special requests.

Develop and implement systems which allow for the flow of information to and from Medical Staff committees into the performance improvement structure.

Maintain and generate performance related data for Medical Staff members and functions.

Orient applicants to the medical staff bylaws, key policies, Medical Staff structure, and performance improvement process.

Stay abreast of and apply knowledge of applicable federal and state laws and regulations and accreditations standards.

Weekly meetings with staff to discuss issues in the office and to streamline processes for better effectiveness.

Approved payroll and pto time.

Planned and implemented Medical Staff Parties for the Physicians, Allied Health and their spouses and partners including the Chief Officers of the Hospital.

Provide technical and administrative support to the Medical Staff departments and committees as assigned which at a minimum includes research and confidential reports.

Prepare agendas, minutes, and follow up action items for the medical staff and specified committees.

Manage the preparation, distribution and maintenance of the Emergency On-call Roster.

Exhibit a high degree of responsibility for confidential matters.

Assumes other related responsibilities as required.

Establish and administer the credentialing, reappointment, and privileging processes.

Prepare agendas, minutes, and follow up action items for the medical staff and specified committees.

Oversee office assistant and conduct annual reviews.

Regulate and maintain/balance Medical Staff account.

St. Catherine Hospital 2002 - 2003

Human Resource Executive Secretary

Responsible for providing executive administrative support to the Director of Human Resources. Establish, maintain and follow organization and administrative departmental procedures. Rely on experience and judgment to plan and accomplish goals. Perform a variety of complicated tasks; directs and leads projects with a wide degree of creativity and latitude

Perform wide variety of tasks which include: correspondence in final form, memos, purchase orders, forms, tables, and records.

Maintain and update departmental records and files; gather data and prepare a number of routine and/or recurring reports.

Assist employees with routine personnel related questions as the first point of contact for employee related issues. Communicate and interpret policies to employees and management personnel.

Distribute incoming and outgoing mail.

Answer incoming calls and transfers to appropriate staff members.

Coordinate special events and functions for hospital employees who include, but are not limited to: Tenure Award Program, Company Christmas Party, United Way Raffle, Open House, Job Fairs, and Training programs.

Assist Director of Human Resources with daily office operations.

Perform related duties and responsibilities as required.

Technical Skills

Microsoft Office Suite 2003 Windows XP PeopleSoft AS/400 Meditech Outlook Avatar

Nextgen

Education/Professional Development

Purdue North Central

Nursing Program; – 1997-2000 – Deans List

High School

Chesterton Senior High School – Graduated 1986

Professional and personal references provided upon request

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