Nicole Mansilungan

About Nicole Mansilungan

Compliance & Risk Management: Fraud Investigations, Enterprise Risk Management…

Experience

1. Credentialing

   Headway

   Aug 2024 — Present · US

   Reviewed, analyzed, and processed provider on-boarding requests, enrollments, dis-enrollments, and updates for Delegated, Non-Delegated, and Government credentialing• Managed credentialing and re-credentialing documents in accordance with Standard Operating Procedures to ensure compliance and accuracy• Entered and tracked data in credentialing/enrollment platforms, conducted payer verification initiatives, and performed regular roster audits• Followed up on applications, delegated spreadsheets, expirations, and provider ID numbers; escalated critical items and tracked enrollment, contractual, and payer issues• Verified provider information using third-party databases such as CAQH, NPPES NPI Registry, and state licensing boards• Adjusted priorities to meet shifting workloads and contributed to operational projects, process improvements, and reporting initiatives• Ensured all work adhered to HIPAA, billing compliance, and organizational policies

Education

• City University of New York-Herbert H. Lehman College

  Bachelor's degree, Dietetics and Clinical Nutrition Services

  2012 — 2016

Skills

• Delegation
• Event Planning
• Multi Tasking
• Powerpoint
• Microsoft Excel
• Leadership
• Initiation
• Observation
• Painting
• Social Media
• Recording
• Presentations
• Planning & Organizing Skills
• Microsoft Office
• Plantings
• Microsoft Powerpoint
• Administrative Work
• Microsoft Word
• Adult Cpr
• Editing
• Photography
• Critical Thinking
• Articulation
• Constructive Feedback
• Advising Clients
• Recruiting
• Community Outreach
• Social Influence
• Customer Service
• Reporting & Analysis
• Event Management
• Public Speaking
• Telephone Skills
• Time Management
• Cooperation