Customer Service Credentialing Specialist
Resume:
TRACY L.
WHITE
**********@*****.***
Dayton, OH 45426
Bold Profile
SKILLS
Motivation
Task prioritization
Training
Problem-solving
Epic
Verbal communication
Organization
Teamwork
Quadax
CAQH
Cactus
Policies
Quality
Management
Microsoft Office Products
EDUCATION AND TRAINING
Indiana Wesleyan University
Dayton • 08/2013
Associate of Applied Science: Business Administration
SUMMARY
Hardworking and reliable with a background primarily in Healthcare Administration. Focused on going above and beyond to support a team and to serve customers. Trained in organization, time management, and customer service, highly motivated to learn and grow as a Credentialing Specialist or Healthcare Administrative Support.
Will bring outstanding interpersonal and communication skills, very detail-oriented, enthusiasm and commitment to strive for excellence would make a great asset to any team or organization.
EXPERIENCE
Premier Health - Credentialing Specialist
Dayton, OH • 10/2019 - 02/2023
Performed immediate and accurate credentialing processes for medical and allied health professionals, while complying with NCQA and Joint Commission guidelines. Execute primary source verification, such as background checks, training, and education. Obtain and examine applications to identify inaccurate information.
Performed proper documentation of correspondence from initial to reappointment processes by organizing 20 -50 credentialing files each month.
Premier Health - Patient Accounts Associate
Dayton, OH • 05/2008 - 10/2019
Devised effective payment plans, as well as managed accounts and refunds. Verified adherence to Medicare billing policies, procedures, and risk management by reviewing, billing, and assessing Medicare claims and edits. Acquired accurate reimbursement by promptly following up on Medicare claims for adjustments.
Enabled Medicare process improvement by developing and implementing new approaches for billing manuals.
Addressed and resolved billing issues for compliance and verified appropriate management of claims by partnering with Medicare/CGS. Managed over50 claims per day.
Dayton Heart Hospital - Supervisor
Dayton, OH • 08/1999 - 05/2008
Interviewed candidates and led recruiting and training of new hires.
Organized disciplinary actions reports by conducting yearly performance reviews.
Provided suggestions to streamline admission process, while performing audits on daily basis to ensure that admission process, while performing audits on daily basis to ensure that registration processed was completed with 100% accuracy.
Guaranteed adoption of standard operating procedures by collaborating with doctors, nurses, and office staff
.
Contact this candidate