Ms. Jakeitha Allen

**** *********** ***.

Houston TX, 77063

ad198z@r.postjobfree.com

713-***-****

Career Summary: Performance-driven and detail-oriented Credentialing Professional with 5 plus years of relevant experience, a proven ability to establish and maintain excellent communication and relationships with clients, while providing exceptional support and ensuring projects are completed on time.

Skills

Proficient in Microsoft Office and SharePoint

Knowledge of Medicaid, Medicare, NCQA, and HIPAA regulations

Employment History

September 2019-May 2022

Credentialing Specialist

Cigna, Houston, TX

Duties

●Facilitated committee review meetings and participated in the acceptance/declination process of accepting providers into our contract.

●Gathered, researched, compiled, verified and documented physician's data that is required to be approved in the Credentialing process.

●Followed-up with practitioners/facilities when files were incomplete, while adhering to the company’s Standard of Conduct at all times.

February 2018-August 2019

Patient Access Rep III

Memorial Hermann Hospital System, Houston, TX

Duties

Monitored, reviewed and resolved patient account issues on assigned reports. Performs account analysis and trending.

Obtained demographic, insurance and financial information from patient or guarantor. Entered information in computer systems with a high degree of accuracy.

Verified insurance eligibility and benefits and ensured all notifications and authorizations are completed within the required timeframes.

August 2016-January 2018

Sr. Customer Intake Specialist

Aetna, Houston, TX

Duties

Identified and resolved the source of complaints, and grievances. Responded to escalated customer inquiries, related to benefits, eligibility, claims, authorizations and referrals.

Managed incoming and outgoing correspondences including referrals, utilization reviews, grievances and appeals decisions

Mentored new hires and reps as a Subject Matter Expert. Completed the Leadership In Training class.

August 2015-July 2016

Credentialing Specialist

Veterans Evaluation Services, Houston, TX

Duties

Gathered, researched, compiled, verified and documented physician's data that is required to be approved in the Credentialing process.

Followed-up with practitioners/facilities when files were incomplete, while adhering to the company’s Standard of Conduct at all times.

Exercised independent discretion and decision-making, with regard to building medical provider interaction and relationships.

March 2010-July 2015

Senior Customer Service Rep

Southwest Water Company, Sugar Land, TX

Duties

Identified and handled priority and escalated issues, incoming calls, and customer complaints, regarding their utility service.

Completed call logs, customer requests, and follow-ups. Worked on special projects for upper management.

Education

University of Houston-Downtown, Houston,TX

2017

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