1. MARY LOU HAGEN
2707 River Bend Ln, Plainfield, IL 60586 | H: (815) 603-8387|C: (630) 603-4737 |
hagenm315@gmail.com
PROFESSIONAL SUMMARY
Experienced manager with thorough knowledge of credentialing requirements and verification processes
common to managed care. Working knowledge of NCQA Standards. Strong working relationships with vast
majority of Medical Groups/IPA’s/ PHO’s in the Chicago Metropolitan area. Detailed oriented. Proficient in
Microsoft office.
PROFESSIONAL EXPERIENCE
January 2015- May 2015
DATA ENTRY CONSULTANT
HFN, Inc –A StratoseCompany –Oakbrook, IL
 Performed Data Entry training for Stratose team members on Provider, Hospital/Facility and Credentialing Vb.net data
bases of the HFN Provider Network.
 Accountable for accurate data entry and maintenance of health providers by performing QA audit.
 Loaded new contracts into database with demographics and rates as required for appropriate PPO Insurance repricing
and reimbursement.
March 2000-October 2014
CREDENTIALING AND DATA INTEGRITYMANAGER
HFN, Inc –A StratoseCompany – Oakbrook, IL
 Managed overall daily activities of credentialing and data entry departments.
 Processed provider credentialing information, including primary and secondary source verifications in accordance with
NCQA and HFN, INC policies and procedures, to support network development and credentialing processes.
 Exceeded production goals by 98% while maintaining quality
 Maintained credentialing database while tracking all direct provider contract data.
 Maintained files for provider with copies of all credentials, verifications and quality issues.
 Provided excellent customer service to practitioners, managers and contacts of Groups/IPA’s and PHO’s that HFN, INC
maintained contracts.
 Prepared and attended monthly Credentials Peer Review meetings.
 Monitored daily data entry activity of data entry specialist for completeness and quality.
 Responsible for performing on site audit of Delegated Entity credentials/recredentials files for correctness, completeness
and compliance with NCQA guidelines.
January 1999 – March 2000
Delegation Compliance –Non Clinical Facilitator – Credentialing
Humana Inc. – Chicago, IL
 Completed pre-assessment tool for entity requesting Delegated Credentialing status.
 Audited DelegatedEntity credentials/recredentials files for correctness, completeness and compliance with NCQA
guidelines
 Report findings following annual audit for Initial and Recredential files to Credentials Manager of the IPA/PHO and
Group. Prepare corrective action plan if deemed necessary.
April 1995 – December 1998
Credentialing Manager
ApertureCredentialing – Oakbrook Terrace, IL
 Supervised Credentialing Specialists
 Assisted VP of Operations with development and implementation of policy and procedures of credentialing process.
 Group roster reconciliations for clients.
 Performed primary and secondary verifications of providers to comply with NCQA standards.
February 1992- August 1994
Office Manager
General Pediatrics Ltd- Naperville, IL Managed daily operation responsibilities of 8- person office
 Oriented and trained new employees in all phases of the medical office
 Processed patient HMO referrals, pre-certifications for Surgery, Physical, Occupational and Speech Therapy.
 Completed credentialing applications for various health plans.

2. September 1983 July 1990
Supervisor Outpatient Services
Edward Hospital – Naperville, IL
 Managed a 15-20 person department of ER/OP registrars
 Ability to handle highly stressful job situations
 Instrumental in the development and implementation of a computerized Central Scheduling
Department
 Developed and implemented policy and procedures for department
 Maintained quality assurance standards for the registration process.
 Cashier duties for payment of services performed
 Balanced and banked out cash drawer at end of shift.
EDUCATION
College of Dupage – Glyn Ellyn, IL
SKILLS
Typing 60 WPM
Microsoft Office Suite
Medical Terminology
REFERENCES AVAILABLE UPON REQUEST