Priyanga M

• Provider credentialing & recredentialing (IOA-Provider services)
  As a Credentialing Specialist, I am responsible for verifying and maintaining providers' licenses, certifications, malpractice insurance, and other required credentials. I ensure all records remain accurate and up to date.

RESPONSIBILITIES

• Performed Primary Source Verification (PSV) of provider credentials in compliance with client and regulatory requirements.
• Verified education, licenses, board certifications, malpractice history, and other credentialing documents.
• Conducted provider and client outreach for issue resolution and timely completion of credentialing activities.
• Maintained accurate provider records and ensured compliance with credentialing standards.
• Managed provider enrollment, reinstatement, and termination processes.
• Participated in internal audits and quality checks to improve process accuracy and reduce credentialing errors.
• Collaborated with cross-functional teams to meet SLA and quality targets.

Transaction Processing Associate – Enrollment/Reconciliation experience.

• Conducted quality assurance checks, reporting discrepancies to management for prompt resolution.
• Managed Enrollment Reconciliation activities, identifying and resolving discrepancies while coordinating with clients and internal teams.
• Managed Enrollment Reconciliation, identifying and resolving discrepancies in collaboration with clients and internal teams.
• Performed quality assurance checks and reported process discrepancies to management for timely resolution.
• Coordinated workload allocation and supported enrollment-related cleanup activities as requested by clients. Collaborated with cross-functional teams to achieve productivity, quality, and SLA targets.