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S T R E E T • A P T . # 7 - D , B R O O K L Y N , N E W Y O R K 1 1 2 3 4
P H O N E 7 1 8 - 2 5 1 - 1 2 1 3 • E - M A I L S I D _ L E I D @ H O T M A I L . C O M
SIDONIE LEID
BJECTIVE To operate as a Provider Relations Specialist, utilizing my acquired training to effectively
Analyze Credentialing Providers and related tasks.
DUCATION COMPUTER CAREER CENTER, BROOKLYN
NY Medical Office Technology/Billing Program
ILLS
XPERIENCE
v 2015 – Present
ne/2010 – Nov 2015
Notary Public. Microsoft Office Suite, Microsoft office 365, Data Entry, Medical Terminology,
CPT-4 Procedure Codes, ICD-9-CM Diagnosis Codes, Evaluation & Management Codes,
Scheduling Appointments, CMS-1500 and Front Office, Fraud & abuse, HIPPA Requirements,
HCPCS, Patient Status and History Information Forms, Medicaid, Medicare forms. NexGen and
Cactus database. OneApp Database.
US Family Health Plan, NY, NY. – Provider Maintenance Coordinator
Evaluate legitimacy of career history and qualifications of licensed medical professionals.
Coordinate, and monitor the review and analyses of practitioner applications and accompanying
documents, ensuring applicant eligibility for the Provider Network.
Prepare credentials file for completion and presentation to the Credentials Committee.
Support Credentialing process by obtaining provider documents as required.
Assist with the processing of Administrative and Credentialing Reports.
Maintain proper documentation of licensure and certification for all medical staff in compliance
with governmental rules and regulations; provide primary source verification and staff credentials.
Maintain a Provider database and locator of medical staff records for re-credentialing and new
appointments; responsible for mailing approval/denial letter and contract.
Advantage Care Physicians/Preferred Health Partners, Brooklyn, NY. – Credentialing
Provider Relations Specialist
Correspond with hospital medical staff for active hospital privileges for physicians.
Direct, coordinate, and monitor the review and analyses of practitioner applications and
accompanying documents, ensuring applicant eligibility.
Prepare credentials file for completion and presentation to the Credentials Committee.
Support Credentialing Vendor by obtaining provider documents as required.
Assist with the processing of Administrative and Credentialing Vendor Reports.
Set up and coordinate Contracting, Revenue Cycle, and Provider Relations meetings with Payers.
Answer queries from other organizations, interacting with internal and external customers on day
to day credentialing and privileging issues.
Maintain proper documentation of licensure and certification for all medical staff in compliance
with governmental rules and regulations; conducts periodic internal file audits.
Coordinate the credential process for medical staff by verifying the credentials and generating the
applications for reappointment and application for clinical privileges.
Maintain current medical staff files along the guidelines of the accreditation standards.
Maintain and update a database to identify medical staff members, types of appointment, and
clinical privileges by department or division; performs queries and generates reports.
Prepare and maintain related records and reports; collect relevant information related to medical
staff reappointment and privileges.
Address and identify issues that require further investigation and evaluation, ascertain
discrepancies, and conduct appropriate follow up.
Monitors the appointment, reappointment and termination process for all contracted, ancillary,
and delegated providers.
Maintain URAC regulations compliance, USFHP policies and procedures and delegated contracts.
Experience with Intelli-Cred Healthcare Credentialing and NexGen Credentialing application.
Verifications of New York State Education Department License, Office of Professional Medical
Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs,
& National Practitioner Data Bank; Verifications of New York State Education Department
Sidonie Leid Resume

2. gust 11/09 – May 2010
b 2008-Aug 7/09
07 – 2008
04 - 2007
04-Internship
License, Office of Professional Medical Conduct, HHS Office of Inspector General, American
Board of Medical Specialties/CertiFACTs, National Practitioner Data Bank and Medicare Empire
Services Opt-Out
Manhattan Physician Group, NY, NY. – Credentialing Associate
Maintain proper documentation of licensure and certification for all medical staff in compliance
with governmental rules and regulations.
Coordinate the credential process for medical staff by verifying the credentials and generating the
applications for reappointment and application for clinical privileges.
Maintain current medical staff files along the guidelines of the accreditation standards.
Maintain and update a database to identify medical staff members, types of appointment, and
clinical privileges by department or division.
Prepare and maintain related records and reports; collect relevant information related to medical
staff reappointment and privileges.
Experience with Intelli-Cred Healthcare Credentialing and NexGen Credentialing application.
Verifications of New York State Education Department License, Office of Professional Medical
Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs,
& National Practitioner Data Bank; Assist with special projects as required
Verifications of New York State Education Department License, Office of Professional Medical
Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs,
National Practitioner Data Bank and Medicare Empire Services Opt-Out
Touchstone Health HMO – Credentialing Associate
Processed initial & re-credential providers’ applications according to NCQA guidelines for
participation in health plan, ensuring that they met the health plan criteria.
Prepared all providers’ charts for presentation at monthly Credentialing Committee Meetings,
checking license sanctions, malpractice history and par hospital privileges.
Managed Medicare Opt-Out verifications; Verifications of New York State Education Department
License, Office of Professional Medical Conduct, HHS Office of Inspector General,
American Board of Medical Specialties/CertiFACTs, & National Practitioner Data Bank.
Inputted company information into Health Database.
Updated providers’ demographics in Cactus database; Operated ABMs Board.
Conducted follow up and phone/fax communications regarding status of applications and missing
documentation; Assisted with special projects as required.
Verifications of New York State Education Department License, Office of Professional Medical
Conduct, HHS Office of Inspector General, American Board of Medical Specialties/CertiFACTs,
National Practitioner Data Bank and Medicare Empire Services Opt-Out
Heavy phone and fax communication regarding status of applications and missing document.s
Saint Vincent Hospital – Patient Access Representative
Worked in Emergency Room; Retrieved patient demographics and insurance; inputted data on
(INVISION SMS) HDX system.
Brookdale Hospital – Radiology Front Desk Clerk
Prepared X-ray films for Radiologists to read; Answered phones; Prepared films for clinics.
Hung up films in ICU for radiologists to read.
Adult Day Health Care –Transportation Coordinator/Clerk
Coordinated arrangements for elder registrants to Dr’s appointments; prepared charts &
discharge charts; arranged round-trip transportation to program; answered phones.
Completed medical billing on adhc software & by hand on 1500 forms.
Brooklyn Hospital, Brooklyn - OB-GYN-Faculty
Verified eligibility & insurance via telephone & internet; did Filing & demographics.
Typed labels for patients’ charts; scheduled appointments for patients on Medical manager.
Inputted diagnosis codes & procedures; checked claim status. Processed patients’ charts for billing.
REFERENCES FURNISHED UPON REQUEST.
Sidonie Leid Resume

3. Sidonie Leid Resume