Manager Office
Resume:
lofl Mfercedes Clark-Terrance
***** ******* ***** ****** ****** Springs, LA 70726
225-***-**** ********.********@*****.***
Professional Summary:
Results-oriented professional, dedicated associate with high integrity, a strong decision-maker who understands the
importance of compassion and patience. Reliable and highly skilled credentialing and office clerk with strong written and
oral communication skills, strong organization and excellent follow up skills, strong client relations, professional
demeanor, excellent interpersonal skills, and ability to effectively communicate both verbally and written with providers,
management, and in a team setting.
Professional Experienc
Blue Cross Blue Shield of Louisiana, Baton Rouge, LA
Provider File and Credentialing Specialist Sept. 2002 - Dec. 2020
My job responsibilities were to receive provider applications, agreements, and various updates, verify accuracy and
conduct research to prepare for credentialing, provider file setup, network participation, and directory file set up of
non-participating & participating providers in order to keep the provider file accurate.
e Requests detailed documentation from providers and external organizations to verify that all required documentation
has been received and is complete to ensure set up or update accuracy.
e Establishes and maintains accurate provider records in the Provider Manager system to allow for comprehensive
reporting capabilities of the providers credentialed within the organization as needed for URAC.
e Answers calls from the Unit toll-free phone line including but not limited to general provider file record, set up
information, network participation status, credentialing status, etc, to education callers on our procedures and answer
their various questions
e Experience with credentialing software (Cactus)
Blue Cross Blue Shield of Louisiana, Baton Rouge, LA
Edit Processor April 1997- Sept. 2002
e My job duties were to analyze, investigate, and resolve edits that were removed by the system in a quick, timely, and
accurate manner.
Blue Cross Blue Shield of Louisiana, Baton Rouge, LA
Claims Processor Feb. 1993- April 1997
@ My job duties were to analyze, investigate, and process claims according to the subscriber’s particular group/policy
Blue Cross Blue Shield of Louisiana, Baton Rouge, LA
Mailroom Clerk Jan. 1986- Jan. 1993
e My duties were to process and distribute mail throughout the company. My primary responsibility included
sorting mail by department and category, forwarding misdirected mail and keeping an inventory of mailing
supplies.
Education:
Southern University and A&M College — Bachelor of Science in Business Education —- December 1985
Denham Springs High School — August 1981
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