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@brendalong
Credentialing Specialist dedicated to improving healthcare quality and compliance.
I am a Credentialing Specialist with over four years of hands-on experience in provider credentialing, payer enrollment, and healthcare compliance. My expertise lies particularly within Federally Qualified Health Centers (FQHC) and managed care environments. I am confident in using tools such as CAQH, NPDB, PECOS, and various payer portals, and I have a strong track record for accuracy and meeting deadlines.
Throughout my career, I have been committed to supporting providers and improving the overall quality of care within underserved communities. I have experience maintaining compliance with NCQA, CMS, and HRSA standards while collaborating across departments to streamline workflows. My organizational skills and ability to manage multiple tasks have been key in ensuring that all processes run smoothly and efficiently.
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Work history, roles, and key accomplishments
Western Wayne Family Health Centers
Jan 2024 - Present (1 year 10 months)
Managed end-to-end credentialing and payer enrollment for medical, dental, and behavioral health providers. Maintained provider files, created tracking sheets for expiring documents, and ensured compliance with NCQA, CMS, and HRSA standards.
Western Wayne Family Health Centers
May 2023 - Present (2 years 6 months)
Helped manage asthma care programs in partnership with the American Lung Association. Supported mobile mammogram screenings with Ascension to boost preventive care metrics.
Western Wayne Family Health Centers
Aug 2021 - Present (4 years 3 months)
Connected patients with community resources and health education, focusing on social needs like housing, transportation, and food access. Partnered with Medicaid plans to support patient outreach and engagement.
Western Wayne Family Health Centers
Aug 2020 - Present (5 years 3 months)
Greeted and checked in patients, verified insurance, and scheduled appointments. Answered phones and helped direct patient inquiries to the right staff.
Degrees, certifications, and relevant coursework
Bachelor of Arts, Sociology
2013 - 2019
Studied sociology at California State University, Fresno. Gained knowledge in social structures, human behavior, and societal dynamics.
Software and tools used professionally
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