Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:

Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.

Qualified employee with expertise in tracking practitioner documentation and exemplary communication skills. An enthusiastic Credentialing Coordinator highly talented in maintaining files, reviewing certifications and following up with the application process.

Communicative Credentialing Coordinator promoting 5+ years to career applying critical thinking and decision-making skills in fast-paced environments. Focused individual managing provider credentialing and submitting documentation.

  • Training and development
  • Practitioner application coordination
  • Credentialing audits
  • Application file verification
  • Data research and analysis
  • Knowledgeable in Microsoft, Word, Excel etc.
  • Facility credentialing
  • Application management
  • Insurance procedures
  • License verifications
  • Proofreading
  • Personnel engagement
  • Patient statements
  • Project management Essentials certified
  • Six sigma white belt certified
  • Lean six sigma certified
Credentialing Coordinator, 11/2016 - 11/2018
Phoenix Children's Hospital Chandler, AZ,
  • Kept close tabs on documentation expiration dates, communicating with correct personnel to submit files prior to expiration.
  • Used Microsoft, Word and Excel to maintain facility databases containing physician records, files and credentialing documents.
  • Collaborated with physicians to ensure timely completion of hospital applications.
  • Utilized well-developed active listening, interpersonal and communication skills in collaborating with diverse individuals each day.
  • Offered high level of assistance during managed care auditing process and conducted internal file audits.
  • Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
  • Performed primary source verifications such as criminal histories, licenses and board certifications.
  • Checked applications for missing information and organized all paperwork.
  • Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access.
  • Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
  • Completed enrollments into Medicaid, Medicare and private insurance plans.
  • Processed documents and status-change requests, conducting followup assessment regarding enrollment inquiries.
  • Set up NPI numbers for providers and facilities and updated current profile information.
  • Performed database queries, compiling information according to requests and logging logistics changes.
  • Tagged documents according to tiered access thresholds, updating packets, reviewing reports and forwarding items requiring approval or verification.
  • Organized records to prepare for site visits by contacting representatives and preparing associated audits.
MANAGER , 11/2015 - 12/2016
Optivest Properties Phoenix, AZ,
  • Trained employees on additional job positions to maintain coverage of roles at all times.
  • Assigned tasks to associates to fit skill levels and maximize team performance.
  • Recruited and hired qualified candidates to fill open positions.
  • Greeted and encouraged feedback from customers to implement in-store operational changes.
  • Conducted inventory counts by assessing current state of inventory integrity against target accuracy levels and tracking variances.
  • Established and created training programs to enhance employee knowledge of best practices, resulting in improved customer satisfaction.
  • Monitored supplier operations to verify quality, delivery schedule and conformance to contract specifications.
SHIFT LEAD/Manager, 08/2013 - 08/2015
  • Provided coaching and reinforced standards to foster superior performance from crew members and others throughout organization.
  • Coordinated shift-based inventory receiving, auditing and restocking.
  • Upheld company standards and compliance requirements for operations and cleanliness.
  • Positioned skilled staff in key areas throughout shift to optimize department productivity.
  • Documented receipts, employee hours and inventory movements.
  • Enhanced operations and boosted productivity through employee training, coaching and creating work schedules and assignments.
  • Generated reports to assess performance and adjusted workflows to realign with targets.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Delegated work to staff, setting priorities and goals.
  • Remained calm and professional in stressful circumstances and when dealing with unhappy customers, effectively diffusing situations.
  • Treated associates with fairness and respect, providing recognition of accomplishments.
  • Demonstrated excellent communication skills in resolving product and consumer complaints.
Education and Training
GED: , Expected in 05/2016
Master of Management: Management , Expected in 12/2018
Management And Strategy Institute - DALLAS , TX

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School Attended

  • Management And Strategy Institute

Job Titles Held:

  • Credentialing Coordinator
  • SHIFT LEAD/Manager


  • GED
  • Master of Management

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