Shawndeanna Hopkins
Credentialing Specialist
Locust Grove,GA
Summary
Accomplished and strategic administrative professional with 10 years of experience driving operational efficiency, transforming processes, and improving client satisfaction across fast-paced environments. Proven track record of streamlining workflows, solving complex problems, and ensuring compliance with organizational standards to consistently achieve measurable results. Successfully implements process improvements that reduce errors by up to 20 percent, enhancing overall operational efficiency. Dedicated to fostering collaboration, supporting cross-functional teams, and building strong client and team relationships that drive long-term organizational success.
Overview
16
16
years of professional experience
Work History
Operations Specialist
Alma
06.2022 - Current
- Lead credentialing and re-credentialing for 5,000+ health providers nationwide, managing full onboarding from intake to payer submission.
- Review 300+ provider files monthly, ensuring 100% compliance with payer requirements and internal standards.
- Maintain and update provider profiles in CAQH and Salesforce; verify licenses, education, board certifications, and NPI numbers for major payers including Optum, Aetna, and Cigna.
- Drive process improvements and automation initiatives, increasing onboarding throughput by 25%, reducing manual interventions by 30%, and cutting average onboarding time by 20%.
- Develop Excel macros, dashboards, and SOPs to streamline credentialing, maintain data integrity, and improve provider paneling success by 15%.
- Train and mentor new team members; serve as subject matter expert on payer-specific workflows and regulatory compliance.
- Collaborate cross-functionally to resolve payer issues, monitor KPIs, and implement strategies that enhance efficiency and compliance.
- Respond to provider inquiries daily, ensuring a high-quality onboarding experience and timely documentation guidance.
Credentialing Analyst
Equifax, Inc
03.2019 - 01.2022
- Ensured compliance for financial partners by credentialing thousands of client accounts, conducting investigations with 200+ third-party data sources monthly.
- Reviewed 800–1,000 files per quarter and audited 150–200 applications weekly, detecting fraud, verifying documentation accuracy, and enforcing FINRA and licensing regulations.
- Reduced credentialing errors by 10–15% through risk identification and implementation of mitigation strategies.
- Streamlined credentialing reviews and reporting by developing Excel tracking tools and managing data in Salesforce.
- Accelerated approval timelines by reviewing, approving, and escalating applications, ensuring timely resolution of discrepancies.
- Delivered training presentations for new team members on credentialing procedures, compliance standards, and documentation best practices.
Loan Documentation Specialist
M&T Bank
05.2017 - 03.2018
- Reviewed and processed 1,000+ mortgage and loan files from origination through closing, ensuring compliance with federal/state regulations and underwriting guidelines.
- Served as primary liaison between Loan Officers, Underwriters, and Mortgage Assistants, reducing loan processing delays by 20% through improved communication and documentation flow.
- Verified borrower financial and personal account information, credentialing sensitive data in strict adherence to confidentiality protocols and compliance standards.
- Coordinated daily mail and secure document transmissions with settlement agencies, cutting turnaround times by 2–3 business days for notarizations and corrections.
- Developed and updated procedural manuals and training resources, shortening new hire onboarding time by 20% and strengthening compliance readiness.
- Conducted technical and quality reviews of documentation packages, reducing audit errors by 15% and improving regulatory consistency.
- Collaborated with cross-functional teams (legal, underwriting, and operations) to assemble loan packages, accelerating approval timelines and improving client satisfaction.
Client Support Specialist
Fidelis Care
07.2016 - 03.2017
- Collected confidential financial information for 300+ clients monthly and guided them through 10+ benefit packages, including Medicaid and ACA-related plans, increasing enrollment accuracy and efficiency.
- Credentialed and re-credentialed 1,000+ clients annually; tracked enrollment status for 200+ providers, staff, and patients across multiple locations, ensuring timely eligibility verification and compliance.
- Ensured compliance of data management plans and office procedures with federal and state regulations, including HIPAA, reducing audit risks and maintaining regulatory standards.
- Assisted in database conversion and maintained accuracy of sensitive client and provider data, supporting seamless operational continuity and data integrity.
- Delivered customer service by resolving inquiries and technical issues, building client trust and improving satisfaction through personalized interactions.
Customer Support Specialist
Sykes, Inc
05.2014 - 06.2016
- Troubleshot 50–75 internal service issues weekly, reducing recurring client disruptions by 20% and ensuring uninterrupted, high-quality care delivery.
- Managed 80–100 inbound calls daily in a fast-paced healthcare environment, resolving inquiries and complaints through professional, empathetic communication.
- Educated clients on policies and procedures, improving compliance and engagement, and fostering long-term trust.
- Utilized Siebel and other CRM platforms to maintain accurate, confidential patient and client records, streamlining data access for clinical and administrative teams.
- Investigated order errors, damaged product reports, and return discrepancies, implementing corrective actions that reduced errors by 15% and enhanced client satisfaction.
- Conducted product and service demonstrations tailored to client needs, increasing utilization of therapy resources and improving treatment adherence.
- Collaborated with clinical, administrative, and supplier teams to expedite service delivery, accelerating resolution and supporting better client outcomes.
Administrative Assistant
City of Buffalo
07.2009 - 07.2010
- Managed high-volume inbound and outbound calls, efficiently directing inquiries to clinical and administrative teams, improving issue resolution speed and client satisfaction.
- Scheduled 40–60 client appointments weekly, coordinated 5–10 team meetings, and managed two supervisors’ calendars and travel logistics, streamlining clinic operations and reducing scheduling conflicts.
- Utilized Microsoft Office Suite to create detailed reports, spreadsheets, rosters, and correspondence for internal and external stakeholders, enhancing operational efficiency and data accuracy.
- Maintained office supply inventory, handled mail and package distribution, and ensured office security by screening visitors and updating logs, contributing to uninterrupted daily operations.
- Developed and maintained spreadsheets and databases to track office performance metrics, client engagement, and administrative workflows, enabling data-driven decision-making.
- Provided onboarding and ongoing training for new administrative staff on office procedures, policies, and performance expectations, reducing errors and improving team productivity.
- Maintained a professional and welcoming reception area, fostering a positive client experience and supporting cross-functional collaboration to optimize office efficiency.
Education
No Degree - Business Administration
Medaille College
Buffalo, NY 05.2001 -
High School Diploma -
Tapestry Charter Highschool
Buffalo, NY06.2013
Skills
Business Development
Process Improvement
Project management
Account Management
CRM Software (Salesforce)
Cross-Functional Collaboration
Client Satisfaction & Engagement
Accomplishments
- Developed standardized workflows or SOPs that improved team efficiency or onboarding speed.
- Proactively took on additional provider credentialing and outreach tasks, completing a multi-week project in days and moving the department from behind schedule to ahead of target.
- Led initiatives typically handled by supervisors, alleviating workload, accelerating project completion, and enhancing overall team productivity.
Timeline
Operations Specialist
Alma
06.2022 - Current
Credentialing Analyst
Equifax, Inc
03.2019 - 01.2022
Loan Documentation Specialist
M&T Bank
05.2017 - 03.2018
Client Support Specialist
Fidelis Care
07.2016 - 03.2017
Customer Support Specialist
Sykes, Inc
05.2014 - 06.2016
Administrative Assistant
City of Buffalo
07.2009 - 07.2010
No Degree - Business Administration
Medaille College
05.2001 -
High School Diploma -
Tapestry Charter Highschool
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