Kyla F.
Mid-Level Credentialing Specialist
Open to offersNew to PlatformAbout
Kyla P. is an accomplished Credentialing Specialist with experience across various states including NY, PA, TX, NJ, and MD. With a focus in the healthcare domain, Kyla has demonstrated expertise in provider enrollment, credential verification, and regulatory compliance. At CBM Medical Management, Kyla processed provider credentialing and recredentialing applications aligned with organizational policies and regulatory standards. She conducted primary source verifications and managed provider records, ensuring accuracy within credentialing databases. Her role required coordination with Medicare, Medicaid, and commercial insurance for provider enrollment and participation, as well as maintaining profiles in CAQH. Furthermore, Kyla has been instrumental in preparing files for credentialing committees, conducting audits, and ensuring compliance with licenses and certifications. Her educational foundation from Catanduanes State University compliments her practical experience, making her adept at managing high-quality healthcare operations.
Experience
Credentialing Specialist
CBM Medical Management · 2023 — 2025Processed applications for provider credentialing and recredentialing following organizational policies and regulatory standards. Conducted primary source verification of licenses, certifications, education, training, work history, and malpractice insurance. Managed provider records within credentialing databases to ensure information accuracy and completeness. Coordinated enrollment and participation with Medicare, Medicaid, and commercial insurance payers. Maintained and updated provider profiles in CAQH and other credentialing platforms. Monitored expiration dates for licenses, certifications, DEA registrations, and malpractice insurance to maintain compliance. Prepared credentialing files for credentialing committee and medical staff leadership review. Communicated with healthcare providers, facilities, and insurance carriers to gather necessary documentation and resolve credentialing issues. Assisted in credentialing audits and accreditation reviews by providing accurate documentation. Tracked application statuses and followed up on outstanding requirements to ensure timely processing.
Skills & Expertise
Education
- Bachelor of Science in AgricultureCatanduanes State University · 2018 — 2022
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