Credentialing Specialist with Process Improvement Focus

Angela Michelle Wynne

*** ************ **, *******, ** 37013 - 615-***-**** - ***************@*****.*** Objective: Energetic, self-motivated, team player seeks position in the field of Credentialing. Desires employment that requires efficiency and development along with growth. Education: Milan High School Milan, TN 38358. Graduate with diploma in 1989. Professional Experience:

Wellpoint Inc - 22 Century Blvd Ste 220, Nashville, TN 37214 01/01/2018 to 04/18/2025

Tasks/duties involved:

Credentialing intake: Responsible for functions of credentialing process, processed applications for credentialing also generated necessary correspondence to obtain required documentation, responsible for acquiring primary source verifications, follow up work, data collection along with data entry, document review and relationship building with providers, practice managers, and interdepartmental personnel. Developed knowledge of Credentialing policies and procedures to maintain compliance with all regulations and standards. Completed weekly and monthly status reports.

Return mail process: Review of Credentialing system to determine if address is available to have another letter sent out or close file for no active address listed. Inventory reports: Actively review and processing of Initial/Re-credential files on Inventory reports including obtaining any information needed for processing including Primary Source Verification.

Voicemail distibution and credentialing email /fax box: Obtain information from devices or voicemail and distribute to correct person/department including taking messages. Committee review files: Outreach/obtain information on initial/re-credential files that are level 2 which need TN Credentialing committee review and approval. Arrange the committee packet

(bookmark and type summary) attach information and add to the committee review tracker. Once committee is done approve/deny/pend files in the system and send letters. Kelly Services - 402 Bna Dr #610 Nashville, TN 37217 05/1/2016 to 12/31/2017

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Tasks/Duties: Same tasks as Anthem Inc. I was working as a temporary employee with Anthem Inc at that time then went permanent.

NHC Homecare - 4601 Carothers Pkwy Ste 250, Franklin, TN 37067 04/01/2012 to 02/01/2016

Tasks/Duties: Data entry including appointments for the nurses, PT/ST/OT, information for entering invoices/fee slips into the system. Telephone operator which includes answering and distribution of calls to the correct person, answering/corresponding with patients with their concerns, and taking messages if necessary. Filing patient documentation in the correct patient file. Scheduling all appointments for the therapists and printing off daily routine schedule for the therapists. Auditing files for the monthly audit for accuracy. Technical Skills: Microsoft office, Excel, Microsoft Outlook, Power Point References:

David Chansuthus (Wellpoint formerly Amerigroup) 615-***-**** Schantel Burgess (Wellpoint) 615-***-****

Val Pinder (Wellpoint) 757-***-****

Todd Hong, Manager (Wellpoint) -515-***-****

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