Remote Provider Data Management Specialist at Sutherland Global (2026-03 – Present)
- Accurately enter, update, and maintain provider information for the Medicaid PDS program
- Validate provider credentialing data, contracts, and demographic information to ensure accuracy
- Ensure that provider records comply with CMS, HIPAA, and state and federal regulations
- Conduct routine audits and reconciliations to maintain data integrity
- Review and input the required data into the health plan system according to process guidelines
- Perform Primary Source Verification with stateboards
- Manage and monitor daily activities to meet established targets
- Work independently to complete tasks within set timeframes and with minimal supervision
- Prioritize and fulfill all job responsibilities
- Adapt to changes based on departmental or business needs
Remote Health Plan Credentialing Specialist at Soal Technologies (2025-07 – 2026-02)
- Responsible for the initial credentialing of providers' applications for enrollment for Sanford Health plans
- Proficient with credential verifications for DDS, DMD, MD/DO, NP, PhD, PT, OT, SLP, LMFT, LCSW, OD, PA, LPCC, and RNs
- Perform Primary Source Verifications NSCH, ABMS, AOA, AMA and run NPDB checks through Credentialstream
- Send verification requests to hospitals/schools for residency and fellowship training
- Monitor and manage the expiration of licenses, certifications, and malpractice insurances
- Follow up with providers to obtain any missing documentation needed to complete the credentialing process
- Ensure compliance with healthcare regulations and accrediting bodies
- Maintain accurate records of credentialing activities and status
- Communicate credentialing updates and verification results to management
- Perform audits of every application before presenting to the committee for final approval
- Liaise with external agencies and regulatory bodies regarding provider credentials
Freelance Dental Credentialing Specialist at MiDentista (2021-04 – Present)
- Process payor enrollment applications for dental providers
- Knowledge of dental provider credentialing, re-credentialing, and accreditation principles NQCA/URAC
- Maintain copies of current state licenses, DEA, malpractice, W-9s, and EFT forms
- CAQH provider updates and attestations per request
- Dental Terminology: proficient with PPO, TMHP, Medicaid/Chip Insurance
- Process Texas Medicaid Revalidation application on the TMHP portal upon requests
- Provided exceptional customer service to ensure satisfaction and resolve any concerns or issues
- Process Medical/Chip/PPO/DMO Dental claims
- Process Pre-authorizations for Dental Treatments
- Ensured strict HIPAA compliance in handling patient information and maintaining confidentiality
Remote Medical Staffing Credentialing Specialist at Nomad Health (2021-11 – 2025-03)
- Facilitate provider onboarding paperwork
- Process compliance files per policies
- Maintained an on-time start rate for travel nurses and allied health providers at 95%
- Conduct primary source verifications and sanction exclusion screenings
- Review medical records, processed background checks, drug screens, and occupational health orders
- Assigned the required skills checklist and competency exams
- Strong knowledge of Joint Commission Standards
- Maintained professional working relationships with providers and clients
- Maintained MSP/VMS database systems
- Support and assist the Credentialing function
- Responsible for maintaining the Credentialing inbox and appropriately responding promptly
- Monitored and notified clinicians of upcoming expiration dates of required compliance documents
- Proficient with Zendesk, Slack, and Textline programs
- Operated independently to help the team achieve goals
Remote Live Chat Specialist at Benco Dental (2020-11 – 2021-11)
- Supervised and supported live chat interactions with customers to guarantee dental orders were handled accurately
- Provided excellent customer assistance by actively listening to concerns and addressing problems with dental orders
- Utilized strong communication abilities with my management team to relay information regarding issues or conflicts related to dental orders
- Demonstrated strong problem-solving abilities to tackle issues and improve customer satisfaction
- Offered technical support for software or hardware problems
- Utilized problem-solving techniques to identify and address technical issues efficiently
Dental Instructor/Externship Coordinator at IDTC Career Center (2018-06 – 2020-07)
- Conducted regular job site visits to assess student performance and provide constructive feedback
- Provided specialized career counseling to help students make informed decisions about their future paths
- Collaborated with faculty to develop a curriculum tailored to diverse learners' needs
- Coordinated externship placements to ensure students gained hands-on experience in their field
- Facilitated student placement in internships and entry-level positions within relevant industries
- Established strong industry partnerships to enhance students' access to job opportunities and networking connections
