Credentialing Team Lead with Compliance Focus

Kristy Daniels

Houston, TX ***** • *****************@*****.*** • 832-***-****

Thank you for allowing me to apply for this position. Over the years, I have gained the necessary skills and qualities that will enable me to perform to a very high standard in the role. I am a strong collaborator who seamlessly integrates into any team. I am commercially aware, which means I understand the importance of taking good care of your customers, so they become long-term advocates of the business. I will always take ownership of complex challenges and problems whenever they arise.

My valuable skills demonstrate diligence, hard work, conscientiousness, a positive attitude, and industriousness, all while effectively organizing and prioritizing my work.

My passion for this type of work, my dedication to lifelong learning, and my desire to support my co-workers in the completion of their duties mean that I will always add value to your organization in my work

PROFESSIONAL EXPERIENCE

Credntialing Team Lead (Contractor)

Life Mental Health, Houston, TX

January 2025-Present

Enrolling and maintaining the participation status of the providers with hospitals and/or insurance companies, as well as verifying demographic information and providing up-to-date licensures to ensure the most accurate information is on file for the providers, and contracting for networks

Ensuring that physicians and allied health professionals comply with all regulatory, accreditation, and organizational standards for both appointment and reappointment

Prepare comprehensive and precise credentialing files while entering all required information into electronic credentialing systems

Implements and monitors procedures and activities related to the credentialing, re-credentialing, and privileging of network providers

Processes providers with applications and re-applications, including initial mailing, review, and loading databases into systems, ensuring high-quality standards are maintained

Serves as a liaison during the credentialing processes, communicating with providers regarding credentialing status and information promptly

Coordinate and monitor licensure, certifications, DEA registration, malpractice insurance, and essential background checks

Identify, track, and promptly resolve credentialing deficiencies, escalating issues as necessary

Assist in managing policies and procedures relating to credentialing and provider delegation maintenance

Initiate and oversee communication with physicians regarding pending items, suspensions, or compliance concerns, Committees, Reporting & Governance

Prepare credentialing materials, action items, and reports for Credentials Committee and Medical Executive Committee (MEC) sessions

Attend relevant committee meetings and present credentials data as needed

Identifies areas of development for employees and works with employees to provide help in professional growth and succession planning

Create monthly and future-oriented reports on pending credentialing matters and approaching expirations.

Security Site Supervisor

Securitas, Houston, TX

May 2020–December 2024

Overseeing the security operations maintains full accountability for the Site and its personnel, systems, and procedures to ensure effective and timely response to alarms, calls of distress, incidents, monitoring CCTV, and other activities

Developing, implementing, coordinating, maintaining, and monitoring enterprise-wide physical security and safety policies, procedures, and guidelines for the protection of employees, information, assets, and the reputation of the organization.

Coordinated for photographing individuals and creating security badges in the security card access system, including inputting and updating information, importing and exporting cardholders' photos, creating, modifying, and assigning card access levels to badges

Responding to user requests includes providing support to employees and staff with badge requests, verifying requests for badge access, assigning access levels as needed, troubleshooting security badge issues, and running weekly badge access reports

Serve as the liaison between the District Manager, Contract Security Management, and Global Security Management

Assists with the staffing of all posts to ensure complete coverage and ensure that officers make timely and thorough daily report entries

Conducted scan points maintenance and regular review of discrepancy reports to ensure 100% checkpoint and tour completion for each post

Verifies site payroll for all Officers, ensures officers comply with reporting for duty, daily records completion, uniform and grooming compliance, attendance, and performance

Review written reports and sign-in sheets to ensure clarity, completeness, accuracy, and legibility

Ensure that officers make timely and thorough daily report entries

Review Post orders and make recommendations for changes to senior management

Ensures all security staff are adequately trained on Post Orders, patrol routine, access control requirements, daily activity reporting, Incident Reporting, and notifications

Works with Client Contact to ensure security staff are performing all Client-required duties, enforcing Client rules and regulations for the site

Watch for irregularities, such as security breaches, facility and safety hazards, and emergencies, and contact emergency responders, such as police, fire, and ambulance personnel, as required

Patrols and physical patrols assigned area on foot as assigned, to ensure personal, building, and equipment security

Receive and respond to emergency and non-emergency calls from employees, outside vendors, law enforcement, and the security field force via telephone, automated alarm monitoring, radio systems, and other systems

Motivates, coaches, and provides leadership to the security staff

Provide feedback to both client and contract security management to mitigate failures and improve performance

Serve as a point of escalation for any inter-company customer service issues related to security operations

Manages the scheduling of Security Officers at client sites; manages the scheduling process to optimize operating results; determines the best resolution to staffing issues and problems

Develop and monitor key performance indicators, determine gaps in performance metrics, and recommend and execute change management techniques for efficiency and quality improvements

Watch for irregularities, such as security breaches, facility and safety hazards, and emergencies, and contact emergency responders, such as police, fire, and ambulance personnel, as required

Patrols and physical patrols assigned area on foot as assigned, to ensure personal, building, and equipment security

Executed and responded to emergency and non-emergency calls from employees, outside vendors, law enforcement, and the security field force via telephone, automated alarm monitoring, radio systems, and other systems

Strengthened and monitored key performance indicators, determined gaps in performance metrics, and recommended and implemented change management techniques for efficiency and quality improvements

Data Administration and Customer Support Specialist

Touch of Class Houston, TX

April 2019–May 2022

Maintaining accurate data records while providing responsive customer service and operational support)

Ensures data integrity, assists customers with inquiries, and supports internal teams by coordinating information, resolving issues, and improving administrative processes.

Monitor data quality and resolve discrepancies or inconsistencies in records and digital files

Generate reports and analyze data to support operational and management decision-making.

Coordinate system updates and assist with testing and documentation of data changes.

Serve as a primary point of contact for customer inquiries via phone, email, or online systems.

Provide timely and accurate information regarding services, accounts, or requests.

Coordinate communication between customers, internal departments, and external partners.

Assist with scheduling, documentation, and workflow tracking for operational processes.

Support special projects, reporting needs, and process improvement initiatives.

Maintain organized records, files, and documentation in accordance with company policies

Education

Enterprise High School

High School Diploma

August 1983- May 1995

Hinds Community College

August 2007-May 2008

Criminal Justice

ADDITIONAL SKILLS

Leadership, communication, training, Warehouse Management Systems experience, MS Office experience, analyze information effectively and consistently, work with flows, processes, and complete assignments within established timelines. Manage multiple tasks and deadlines effectively, ensuring accurate and timely processing of tasks

Contact this candidate