Detail-oriented and results-driven Credentialing Specialist / Customer Service / Healthcare Document Specialist with over 14 years of experience in customer service and healthcare documentation. Proven ability to manage full-cycle credentialing processes, verify provider credentials, and ensure compliance with HIPAA standards. Adept at using tools such as CAQH ProView, PECOS, Modio, and Availity. Skilled in handling digital documentation, insurance panel participation checks, and exclusion list verification. Strong communicator with extensive experience supporting healthcare providers and coordinating with payers, licensing boards, and insurance panels. Recognized for building efficient systems and fostering provider trust through accuracy and timeliness.
