Detail oriented Credentialing outreach tracking specialist with extensive experience in Primary Source Verification (PSV) and managing provider network status and data validation. Proficient in ensuring accuracy and compliance in TIN/NPI linkages to support seamless operations and minimize credentialing related claim rejections.
Experience: 2 - 5 years
Mitigate organizational risk by serving as a primary gatekeeper for healthcare compliance, verifying the authenticity of professional licenses, education, and certifications directly through issuing institutions to ensure 100% credential validity. Managed CAQH profile maintenance and quarterly attestations to ensure zero gaps in credentialing.
Experience: 1 - 2 years
Executed data and order entry tasks with a focus on accuracy and efficiency, achieving a data entry accuracy rate of over 98%.
Experience: 2 - 5 years
Managed the verification of Payer-Provider data validation and linkages (TIN/NPI), ensuring 100% alignment of Payor IDs, Provider IDs, and effective dates to guarantee seamless claim processing.
Experience: 2 - 5 years
Collaborated with cross-functional teams to streamline credentialing workflows, enhancing compliance adherence and reducing errors.
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