citiponco Biz
@citiponcobiz
Experienced credentialing and quality operations specialist driving efficiency, compliance, and data integrity.
United StatesWhat I'm looking for
I am a credentialing and quality operations specialist with extensive remote experience improving processes, training teams, and ensuring compliance with NCQA, URAC, and Joint Commission standards. I led credentialing for multi-provider networks, managed migrations to cloud systems, and supported audits with strong documentation practices.
My work has reduced credentialing turnaround times by 30%, supported successful onboarding of 50+ providers during an acquisition, and improved team productivity by standardizing practices. I also trained new credentialing staff and helped migrate records to cloud-based systems to enhance accessibility and security.
I bring practical experience in quality operations, data integrity, and process automation, having overseen operational improvements that increased efficiency and reduced costs. I am bilingual in Spanish, proficient with MS Office, and skilled in credentialing systems and reporting.
Experience
Work history, roles, and key accomplishments
Credentialing Coordinator
BPA International
Feb 2023 - Present (2 years 7 months)
Coordinated day-to-day credentialing and recredentialing for a multi-provider network, reducing document-collection delays and improving file accuracy to support successful audits with minimal findings.
COLed quality operations initiatives, automating workflows to increase operational efficiency by ~20% and supporting cross-functional teams to maintain a 95% customer satisfaction rate.
COManaged credentialing files for 75+ providers, improving turnaround times by 15–20% through early bottleneck resolution and proactive payer/internal communications.
SFAccount Representative
State Farm
Sep 2013 - Jun 2015 (1 year 9 months)
Managed customer appointments, identified needs, and marketed appropriate insurance products, consistently meeting and surpassing sales quotas while delivering prompt, accurate service.
Team Supervisor
DLC Paint Co
Jul 2007 - Jun 2013 (5 years 11 months)
Led a team of 10, managed scheduling and work coordination, trained new hires, and ensured project completion to client standards.
Education
Degrees, certifications, and relevant coursework
PFPenn Foster
High School Diploma, General Education
High School Diploma completed through Penn Foster, covering core secondary education requirements.
PFPenn Foster
Certificate, Business Administration
Completed coursework in Business Administration through Penn Foster.
ATI Enterprise
Bootcamp Certificate, Graphic Design
Completed a Graphic Design bootcamp covering practical design skills and tools.
Design Well Co
Bootcamp Certificate, Digital Marketing
Completed a Digital Marketing bootcamp focused on digital marketing tactics and tools.
Availability
Location
United StatesAuthorized to work in
Job categories
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