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Credentialing Specialist

Location:
Minneapolis, MN
Posted:
July 15, 2023

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Resume:

Michael Helget

612-***-****

adybn3@r.postjobfree.com

Successful business owner that launched and managed a profitable business with consistent increases in annual profits. Exemplary communication skills with thorough knowledge and experience in all aspects of business operation including sales, marketing, record keeping and a natural ability to provide excellent customer service with a guaranteed 100% satisfaction rate.

SELECTED SKILLS/EXPERIENCE

Live Entertainment, DJ & Event Coordinator

•Generate and maintain a constant roster of clients seeking music, lighting and entertainment for weddings, private parties and similar corporate and social events

•Continually seek and develop new customer base by utilizing all available promotional opportunities and maintaining regular contact with local event coordinators and entertainment directors

•Determine customer's specific entertainment needs and use information to generate legally binding business agreement

•Set up audio and lighting systems and provide MC and DJ services as necessary to fulfill specific client needs and meet contractual requirements

•Hire, train and supervise additional DJ’s as needed in all aspects of operations including setting up and tearing down sound and lighting equipment and providing entertainment as needed

Medical Credentialing

•Verify all information on applications submitted by health care providers and request additional information and documentation as needed

•Conduct primary source verifications of all degrees, certificates and licenses and enter PHI into multiple MHP databases

•Prepare and present quarterly reports indicating current workload, progress and applications completed for MHP’s Quality Management Committee

•Fulfill all outside requests for practitioner license verifications and peer references in a timely and confidential manner while complying with all regulatory standards

•Conduct annual audits of network affiliates’ credentialing and record keeping processes to ensure 100% fulfillment of all NCQA and MDH requirements

•Provide customer service to network healthcare professionals for any and all matters related to applications, credentialing, licenses and certifications

Customer Service/Data Entry

•Receive incoming orders through order management portal and enter all information into company database with 100% accuracy and in a timely manner

•Clarify order discrepancies, process credit card payments and provide same day order status requests to customers as needed

EMPLOYMENT HISTORY

Order Management Specialist - Showdown Displays - Brooklyn Center, MN 3/2022 - 2/2023

DJ/Event Coordinator - Self Employed - Minnesota & Wisconsin 4/2008 - 3/2020

Sr Community Healthcare Professional - Metropolitan Health Plan - Mpls, MN 3/2012 - 12/2014

Credentialing Specialist - Hennepin County Medical Center - Minneapolis, MN 4/2009 - 2/2011

EDUCATION

B.A. Journalism - University of Minnesota - Twin Cities Campus



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