Real Time Analyst | Real-time Monitoring, RTOS, Data Acquisition | Provider Credentialing | Provider Onboarding | Healthcare Insurance Claims | Healthcare Insurance Benefits | Administrative Assistant
Detail-oriented Credentialing and Provider Enrollment Specialist with experience managing end-to-end credentialing, payer enrollment, and primary source verification. Skilled in working with insurance payers, maintaining regulatory compliance, and managing credentialing documentation to ensure timely provider network participation. Experienced in healthcare operations, claims investigation, and performance analytics within fast-paced healthcare and contact center environments.
Healthcare Operations
• Provider Credentialing
• Provider Enrollment
• Recredentialing
• Benefits Verification
• HIPAA Compliance
• CPT / ICD-10 / HCPCS Coding
• Payer Portals and Payer Policy Review
• Claims and Billing Systems (EMR/EHR)
• CAQH, PECOS, NPI Registry
• Credentialing Lifecycle
• Provider Data Management
Tools & Systems
• Microsoft Office Suite
• Google Workspace
• Intercom
• Live Chat Support Systems
• Advanced Excel (PivotTables, VLOOKUP, XLOOKUP)
• Typing Speed: 45–55 WPM
Analytics & Quality Assurance
• KPI Monitoring (AHT, ASA, Service Level, Occupancy)
• Real-Time Reporting and Dashboard Monitoring
• Data Validation and Auditing
Experience: 2 - 5 years
Experience: 1 - 2 years
“I have found someone who is smart, has a great work ethic and is easy to work with.”
Sara Brumfield
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