A versatile healthcare professional with a robust background in credentialing, onboarding, and prior authorization across diverse healthcare systems. Experienced in managing provider onboarding processes, ensuring compliance with state and federal regulations, and streamlining credentialing workflows. Skilled in utilizing industry-specific tools such as CAQH, Greenhouse, Credential Stream, Modio, and PEGA PAS to support seamless enrollment and re-credentialing. Demonstrated expertise in handling complex prior authorization requests, collaborating with healthcare providers, and ensuring timely approvals. Known for consistently meeting KPIs, driving efficiency, and delivering high-quality service in dynamic environments.
Experience: 5 - 10 years
US Healthcare Insurance
Experience: 2 - 5 years
Experience: 1 - 2 years
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