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Niketa Dixon

Niketa Dixon

Hospital Credentialing Specialist

Radiology Partners

Greater Chicago Area, us

Experienced Credentialing Specialist with a demonstrated history of working in the health wellness and fitness industry. Skilled in Healthcare, Office Administration, Medicine, Invoicing, and Medical Billing. Strong healthcare services professional with a Associate's degree focused in Medical Billing and Coding from Banner In...

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Radiology Partners

Hospital Credentialing Specialist

Radiology Partners is the largest and fastest growing on-site radiology practice in the US. We are an innovative practice focused on transforming how radiologists provide consistently exceptional services to hospitals, imaging centers, referring physicians and patients. With our state-of-the art clinical technology, specialized expertise, access to capital, and retention of top physician talent, Radiology Partners reliably exceeds the expectations of our clients, patients, and partners. We serve our clients with an operational focus, and, above all, a commitment to quality patient care. Our mission is To Transform Radiology.
• Compiles and maintains current and accurate data for all providers
• Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
• Maintains corporate provider contract files
• Maintains knowledge of current health plan and agency requirements for credentialing providers
• Sets up and maintains provider information in online credentialing databases and systems
• Tracks license and certification expirations for all providers to ensure timely renewals
• Ensures practice addresses are current with health plans, agencies and other entities
• Tracks license, DEA and professional liability expirations for appointed providers
• Audits health plan directories for current and accurate provider information
• Create and maintain radiologist credentialing files
• Research and obtain verifications of radiologist credentials
• Coordinate with hospital/center and radiologists to complete credentialing process, including any additional documentation, verifications, references, and applications necessary
• Complete and review all applications to ensure accuracy prior to submission

Chicago Health System Inc

Credentialing Specialist

• Provides management and supervision for the credentialing and re-credentialing process for Chicago Health System in compliance with health plan requirements for the State of Illinois and the National Committee for Quality Assurance (NCQA).
• Provides delegated credentialing functions for the Chicago Health Medical Group employed physician groups for non-risk products, as well as delegated credentialing functions for any Clinical Integration related products.
• Supervises and collects reviews, discusses and makes recommendations concerning practitioners’ applications for initial acceptance and recredentialing into the CHS network. Performs and/or oversees primary source verification through recognized entities.
• Facilitates a monthly credentialing committee meeting to present new and recredentialing applicants and discuss new and pending issues. Prepares the agenda, minutes and credentialing files for the Credentialing Committee.
• Works with auditors to ensure that CHS is in compliance with our delegated agreements and the NCQA requirements.
• Oversees and/or performs physician office site audits with Quality Coordinators and/or Provider Relations Coordinators to review the office facilities and medical record keeping practices for new primary care practitioners joining CHS network as required by NCQA. Also conducts delegated audits for sub-delegated entities.