Kristen King

Detail-oriented Credentialing and Healthcare Operations professional with over 15 years of experience in provider credentialing, enrollment, and practice management. Proven track record of maintaining compliance, managing audits with 100% success, and improving operational workflows. Skilled in onboarding, training, and leading teams while ensuring accuracy and efficiency. Seeking a remote opportunity with a collaborative team.

Associate Credentialing Manager - Epic Government (formerly FSR) - Annapolis, MD

(2023-03)

• Credential physicians, allied health professionals, and nurses for military bases and state agencies
• Maintain credentialing files with less than 1% return rate
• Complete and submit facility applications and ensure compliance with Joint Commission, CMS standards
• Led monthly meetings and maintained strong physician relationships
• Perform primary source verification (PSV) for licenses, education, and certifications for all providers
• Completed Background for all new hires and also for recredentialing
• Monitor license expirations and ensure timely renewals
• Conduct NPDB, OIG, NSO, and Tricare sanctions checks
• Verified Malpractice and history of claims
• Obtained Clinical References
• Verified up to 10 years of employment/affiliations
• Coordinate drug screenings and onboarding requirements
• Scheduling Fingerprints, Medical Requirements
• Train new team members and develop SOPs and Training Guides
• Perform file audits and maintain 100% audit compliance for Company and Joint Commission
• Conduct employment verifications and obtain clinical references
• Provide coaching and performance support to staff
• Ensure Credentialing Team meets or exceeds KPIs
• Lead Credentialing Committee Privileging Meetings
• Weekly 1:1 with each Credentialing Specialist

Lead Credentialing Specialist - SOH Dental - Chesterfield, MO

(2021-01 - 2023-03)

• Managed provider enrollments with multiple insurance companies
• Completed new enrollments and re-credentialing applications
• Maintained licenses including DEA, CDS, malpractice, and CAQH profiles
• Negotiated insurance fee schedules and resolved payment issues
• Ensured providers were fully credentialed prior to patient care
• Set up EFTs and monitored enrollment statuses
• Generated reports and tracked application progress
• Trained staff on insurance policies and procedures

Practice Manager of Operations - Heartland Dental - St. Louis, MO

(2016-05 - 2018-11)

• Managed daily operations, scheduling, and staffing
• Supported credentialing compliance and license tracking
• Oversaw billing, insurance posting, and accounts receivable processes
• Analyzed P&L reports and implemented strategies to meet financial goals
• Led hiring, onboarding, and payroll submission
• Reduced insurance aging and improved collections processes
• Coordinated patient financial plans and insurance verification
• Coached and mentored team members to improve performance
• Developed team incentives and maintained high engagement

Accounts Receivable Specialist - Southern Medical Corporation - Baton Rouge, LA

(2009-11 - 2015-10)

• Posted insurance and patient payments and charges
• Managed insurance reports and appeal processes
• Worked with ICD-9/ICD-10 and CPT coding
• Handled patient communications and financial arrangements
• Prepared accounts for collections and maintained aging reports

Credentialing Specialist - Lake Surgery Center - Baton Rouge, LA

(2004-01 - 2009-10)

• Managed full credentialing lifecycle for providers and medical staff
• Verified licenses, DEA, CAQH, PECOS, and malpractice coverage
• Conducted NPDB queries and primary source verifications
• Obtained References required for Credentialing and ReCredentialing
• Prepared files for credentialing committee approval
• Ensured compliance with CMS and AAAHC guidelines
• Assisted with patient registration as needed