Ty (Walker) Daley

Philadelphia, PA

347-***-****

adufa0@r.postjobfree.com

*/****-******* **** *******, PC HQ in Los Angeles, CA 90064 Healthcare Tech Company

Remote Credentialing Specialist HQ in Los Angeles, CA 90064

● Track/update new hires via Monday.com

● Onboard/Maintain/Offboard employee credentialing data via MDStaff

● Update medical provider data in CAQH and Availity

● Submit enrollment applications/rosters to Medicaid, Medicare PECOS and contracted insurance plans

● Humana DCE (Direct Contract Entity) report submissions

● OIG sanction checks and Checkr background checks 5/2015-3/2020 Comprehensive House Call Medicine, PC Brooklyn, NY 11204 Multi-Specialty Home Visit Medical Group

(Acquired by Heal Doctors, PC)

HR Generalist/Credentialing Specialist

● Credentialing/Payor Enrollment: submitted enrollment applications and/or complete managed care rosters.

● Post Jobs: met with hiring managers, researched compensation, posted jobs on job boards

● Sourced:candidates and updated ATS, and follow up with hiring manager for feedback

● Onboarding: Sent out required HR documents i.e. Offer Letters, Compliance documents i.e. W4, 1-9 verifications, and handbookADP direct deposit forms

● Employee Relations: Cobra, LOA, Unemployment, Benefits, Holiday Party, and Employee Appreciation events

● Acquisition: Assisted with due diligence prep and by submitting change of ownership documents necessary for new owner to receive payment on claims

1/2013-4/2015 Amida Care New York, NY 10122

Special Needs Health Insurance Plan

Senior Credentialing Coordinator

● Processed Ancillary/Facility/Provider applications

(Article 28/FQHC) and Provider (HIV PCP, PCP, Behavioral Health and Specialist)

● Loaded contract data in Amida Care database after Chief Medical Officer approves providers for billing, member services and other

● Issued provider ID numbers and effective date to providers via Welcome Letters.

10/09-1/2013 Housing Works, Brooklyn, NY 11201

A Socioeconomic Non-profit organization

Credentialing Specialist/Recruiter

● Managed the credentialing/contracting process from beginning to end for each plan

● Sourced candidates via LinkedIn, ADP Recruitment (Applicant Tracking System), Facebook, Bullhorn, job fairs, and alumni associations for administrative, maintenance, management and clinical positions

● Created job posts using ADP Recruitment module, coordinated the start dates of new hires and assisted with salary negotiation and drafted official offer letters

1/2008-10/09 The Brooklyn Hospital Center, Brooklyn, NY 11201 Supervisor, Medical Staff

● Provided demographic reports to Finance, Clinical, Risk Management, and Administration

● Analyzed and input data in Visual Cactus to update provider demographics for board approval letters to be created 10/2004-1/2008 Health Plus, Brooklyn, NY 11201

Health Insurance Plan acquired by Amerigroup-Empire BlueCross BlueShield Provider Relations, Credentialing Specialist

● Conducted primary source verification of provider files

● Loaded approved provider files in Facets and sent out welcome letters EDUCATION:

Pace University- White Plains Campus

Graduate Program-Healthcare Administration

MPA-in process

CUNY – City College, New York, NY

B.A., Liberal Arts Degree holder

SKILLS:

Microsoft Office,Medicare (PECOS), ADP Recruitment Module (ATS), CAQH (credentialing database), FACETS (contract loading), Visual Cactus (credentialing database), MDStaff (credentialing database) and Modio (credentialing database), Monday.com (project management tool), GSuite