Mike-Ryan Mofor
Laurel
Summary
Credentialing professional with strong focus on compliance, process optimization, and quality assurance. Demonstrates keen ability to lead, mentor, and collaborate with cross-functional teams to achieve organizational goals. Known for adaptability and reliability in managing credentialing workflows and ensuring regulatory adherence. Skilled in data management, communication, and problem-solving to drive results and enhance operational efficiency.
Overview
5
5
years of professional experience
Work History
Credentialing Manager
Commonwealth Care Alliance
05.2022 - 10.2024
- Served as the lead of a credentialing team to meet productivity and accuracy targets, achieving a 98% success rate in meeting SLA goals
- Streamlined billing documentation processes, reducing submission errors by 15%
- Processed ICD-10 procedural requests ensuring timely patient care
- Reviewed and approved patient insurance coverage, reducing claim rejections by 20%
- Maintained and updated EMR data, resulting in a 25% improvement in data retrieval efficiency
- Communicated effectively with applicants and customers, reducing documentation delays by 30% through proactive follow-ups
- Facilitated the collection of structured data, enhancing service decision accuracy by 10%
Onboarding and Care Coordinator
Elites Care
08.2020 - 04.2022
- Recruited and screened qualified candidates, improving the talent pool quality by 15%
- Developed and distributed comprehensive patient care plans to over 50 contracted caretakers
- Coordinated with primary care physicians, ensuring accurate treatment plans and boosting patient satisfaction scores by 25%
- Ensured accuracy of provider data in internal databases through regular review and updates.
- Facilitated smooth communication between departments, fostering collaboration in support of credential management objectives.
Healthcare Administrative Intern
Innovative Pain Solutions
03.2020 - 07.2020
- Assisted with daily administrative tasks including scheduling, patient intake, and data entry
- Coordinated with healthcare providers to ensure smooth patient flow and minimize wait times
- Maintained work queues at optimal levels, ensuring 100% compliance with departmental standards
- Analyzed and resolved billing edits, reducing outstanding billing cases by 30%
- Managed medical records and ensured compliance with privacy regulations
- Supported billing and coding tasks, improving accuracy and reducing claim denials by 15%
Clinical Program Manager Intern
National Institutes of Health
05.2019 - 02.2020
- Worked closely with cross-functional teams (clinical operations, data management, regulatory affairs, etc.) to ensure compliance with Good Clinical Practice (GCP) and regulatory requirements
- Monitored study progress and provided regular updates to project managers and stakeholders, identifying potential risks and recommending mitigation strategies
- Assisted in the preparation of clinical trial documentation, including study protocols, informed consent forms, and regulatory submissions
- Supported the planning and execution of site initiation and monitoring visits, ensuring adherence to study protocols and timelines
- Contributed to the development and tracking of project timelines, ensuring all milestones were met and potential delays were proactively addressed
Education
Bachelor of Science - Interdisciplinary Studies-Biology & Community Health
Salisbury University
Salisbury, MDMaster of Public Health -
American International College
Springfield, MASkills
- Project management
- EHR
- Compliance
- Clinical Knowledge
- Healthcare Administration
- HIPAA
- Risk Management
- Excel
- PowerPoint
- Networking
- Effective Communication
Accomplishments
- Supervised team of 24 staff members.
Timeline
Credentialing Manager
Commonwealth Care Alliance
05.2022 - 10.2024
Onboarding and Care Coordinator
Elites Care
08.2020 - 04.2022
Healthcare Administrative Intern
Innovative Pain Solutions
03.2020 - 07.2020
Clinical Program Manager Intern
National Institutes of Health
05.2019 - 02.2020
Master of Public Health -
American International College
Bachelor of Science - Interdisciplinary Studies-Biology & Community Health
Salisbury University
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