At Sutherland Global Services, I support Humana’s provider network through end-to-end credentialing, from application intake and license verification to sanction checks and committee review.
I handle recredentialing and revalidation under NCQA and URAC standards, and process payer enrollment and re-enrollment requests for individual and group providers. I also conduct primary source verification with licensing boards, DEA, OIG, and NPDB.
I maintain provider records and follow up with providers and office administrators to resolve discrepancies and collect missing documents. I maintained 95%+ quality accuracy on credentialing files over consecutive quarters and was recognized for zero critical errors in payer enrollment submissions.
