Akilah Reeves
Novato, CA *****
510-***-**** –(P)
*************@*****.***
SKILLS
Proficient with Internet / Microsoft Office/Excel/QuickBooks
Data entry, database management, multiple phones, filing, general office support
Excellent verbal & written communication/ ability to research and analyze data
Customer service, staff training, employee relations
EKG, vital signs, injections, urinalysis/drug screening
Orientation and onboarding, employee relations
HR policies and procedures
WORK EXPERIENCE
Credentialing Specialist II– Centene Corp, San Rafael, CA 2019-2020
Processes credentials applications and privileging functions to comply with internal requirements
Inputs credentialing data into the database and maintains provider information in the credentialing system.
Updated the database with new providers and changes in providers information.
Attend and participate in meetings, coordinate complete follow-up task.
Managed 40-60 files in different stages of credentialing process to properly prioritize workload.
Credentialing Specialist– BlueShield, San Francisco, CA 2018-2019
Processes credentialing and re-credentialing applications including primary source verifications.
Inputs credentialing data into the database and maintains provider information in the credentialing system.
Assist with monitoring sanction activity and conduct verifications for expiring license.
Performs additional duties, special projects and task as assigned.
Credentialing Manager – Marin Medical Practice Concepts, Novato, CA 2015-2018
Manages the CVO credentialing process for all health system clinical providers, in accordance with AAAHC, NCQA and accreditation standards.
Coordinates the management of the electronic credentials application, to ensure distribution receipt, processing and timely delivery to health system entity.
Monitors and reports turnaround times for processing of credentialing applications
Prepares for and coordinates credentialing audits in compliance with the managed care delegated credentialing contracts.
Credentialing Specialist – Hospice by the Bay, Larkspur, CA 2014-2015
Perform credentialing and re-credentialing activities per plan specifications and in compliance with NCQA standards.
Communicate with professionalism with physicians, check work history, criminal background followed up with office managers, providers and other third parties to secure needed information.
Responsible for tracking, and filing credentialing applications within established standards
Maintained employee’s files, monitored vacancies, updated policies and procedures and informed CEO of progress and or potential problems as they arise.
Maintains and initiates all facilities related licensure.
Credentialing Coordinator/Human Resources- Greenbrae Surgery Center, Greenbrae CA 2012- 2014
Scheduled and coordinated surgery case event with external physicians’ offices
Updated and created all physicians’ credentialing documents
Complies and maintains current and accurate data for all providers
Ensures practice addresses are current with health plans, agencies and other entities.
Working closely with varies Departments, assisting line managers to understand and implement policies
And procedures.
EDUCATION
Certified Medical Assistant: Silicon Valley College, Walnut Creek, CA 2005