Credentialing Specialist

PALMA MULQUEEN

*** ******* ****** **. ************* TN 727-***-****

*********@*****.*** ********@*******.***

OBJECTIVE

To obtain a position where my customer service to patients a provider service background skills can be utilized.

SKILLS AND ABILITIES

Microsoft products 95-2011, Symplr, Cactus, MDreview, EDGE, Cerner EMR,etc.

EXPERIENCE

Baycare Health Systems CVO ONSITE/Baycare Medical Group REMOTE

Credentialing Specialist remote 9/2012-present

Performed background checks, wrote check requests, used NPDB database for claims, verified by psv for Education, training DEA, licensure, CME, peer references, board certifications etc. Ongoing monitoring all documentation to ensure they are up to date with correct specialties. Used the OIG and EDGE to query any unsavory characteristic. Helped providers complete their applications for reappointment and initial applicants.

Onboarding of providers for our health care system and our health plan. Input correct taxonomy codes and tax id information, NPI, Medicare, Medicaid numbers.

Baycare Health Systems 6/2010-8/2012

Front desk /Patient Registration scheduling

Scheduled patient exams, answered phones provided customer service. Registered patient for exams, x rays routine check ups.

Caremedic Technical Support 11/2009-2/2011

Provided technical support for payors claims to go through, password resets. Troubleshoot provider software/hardware issues.

St. Luke’s Medical Center 4/09-8/09

Medical billing collections scheduled appointments for patients collected on past due accounts, scanned ran insurance documentation.

Quality Health Plans 4/08-1/09

Credentialing Specialist enter data as above in a timely fashion with no errors.

Ran government reports to inquire on malpractice cases and licensure issues.

Also Credentialing specialist at WellCare Health Plans. 4/01-12/05

EDUCATION

SUNY New Paltz, NY 1992

B.A. Cummunications

Received full scholarship for certification in Electronic Medical Records and Healthcare Informatics at St. Community College 2009

REFERENCES

Michael MacDonald. City of Clearwater Marine and Aviation Director. 727-***-**** or 727-***-****

Michael Wagoner 727-***-****

Contact this candidate