Sheila McCloud

Experienced Credentialing Specialist with over 5 years in the healthcare industry. Skilled in verifying healthcare provider information, collecting and verifying provider data, and managing credentialing applications.

Credentialing Coordinator - Imedview, Inc - Saugerties, New York (Remote Position)

(2024-12)

• Maintain and update provider profiles in CAQH, ensuring accuracy and staying compliant within company guidelines.
• Coordinate together with providers to gather and collect required documentation such as board certifications, medical licenses, current w9 and CV's, malpractice and liability insurance, etc.
• Prepare and submit enrollment and re-enrollment applications for healthcare providers and commercial insurance plans.
• Track applications statuses and follow up with payers to ensure timely processing.
• Monitoring and managing re-credentialing and revalidation timelines to ensure continuous participation
• Help assist with audits and reports related to provider enrollment activities
• Verification of provider eligibility and ensure alignment with payer - specific participation requirements.
• Being highly responsive to inquiries from providers and internal departments regarding enrollment status and requirements
• Communicating updates in real time and ensuring timely on boarding of internal stakeholders.
• Collaborating with the operations and billing team to ensure providers are billable and active with contracted payers to ensure that all transactions run in a smooth and efficient manner.

Physician Credentialing- Recruitment - CHG Healthcare (CompHealth Locums) - Midvale, Utah (Remote Position)

(2021-04 - 2024-08)

• Supported end to end provider recruitment and on boarding for locum tenens physicians across inpatient and outpatient settings.
• Collected, reviewed, and validated credentialing documentation including CV's, state licenses, DEA registrations, board certifications, and malpractice insurance.
• Assisted with completion and submission of credentialing applications.
• Performed quality checks to ensure accuracy and completeness of provider files prior to submission.
• Coordinating with internal departments regarding provider documents and background screenings.
• Proactively followed up on missing documentation and resolved credentialing discrepancies to prevent delays.
• Maintained tracking logs to monitor credentialing status, ensuring deadlines and turnaround times were met.
• Supported payer enrollment activities and coordinated logistics such as provider travel and lodging as needed.

College Admissions Recruiter - Florida Technical College -MSCHE - Orlando, FL (Hybrid Position)

(2020-01 - 2021-02)

• Interviewing, evaluating, and admitting students into the institution via phone, and email.
• Explaining the schools' policies, guiding the student through the admittance process.
• Supported intake, screening, and on boarding processes by reviewing applications and coordinating communication via phone and email.
• Guided individuals through on boarding requirements, ensuring understanding of policies, procedures, and next steps.
• Conducted database checks and validations to ensure accuracy and completeness of records.
• Facilitated on boarding readiness by coordinating orientation activities and ensuring all requirements were met prior to start.
• Helped to gather all necessary admissions proof of graduation requirements. (POG)
• Assisted with qualifying students through the NSLDS check for financial aid purposes.
• Maintained consistent processing volumes while managing a hybrid workload, ensuring timely completion of on boarding tasks and adherence to deadlines.
• Helped engage students with their new student orientation on first day of classes.
• Enrolled anywhere between 8 to 12 students per every 4-week semester on a consistent basis.
• Worked on campus and via remote, hybrid schedule due to the safety practices regarding Covid 19.

College Admissions - Senior Recruiter - Fortis College/Education Affiliates - ACCSC - Winter Park, FL

(2015-09 - 2019-11)

• Supported overall operations and on boarding processes, including intake, admissions, and enrollment activities.
• Managed front-end administrative tasks such as answering phones, filing, and processing incoming documentation.
• Conducted screening interviews and provided guidance on requirements, timelines, and next steps.
• Assisted with on boarding and training of new team members, including process walk through and system support.
• Coordinated and administered assessments to evaluate eligibility and readiness, ensuring accurate documentation of results.
• Collaborated with cross-functional teams to communicate requirements and support timely completion of on boarding tasks.
• Organized and supported campus events to enhance engagement and streamline boarding efforts.
• Demonstrated adaptability in a fast – paced environment while maintaining accuracy and meeting deadlines.
• Guided individuals through on boarding requirements, ensuring understanding of policies and procedures.

Bachelor of Arts - Human Services - Columbia College (2012-05)

Associate of Arts - General Studies - Columbia College (2010-05)