Della Brock

***** ******** **** ********, ** ****3

adrdbx@r.postjobfree.com 619-***-****

Results-oriented professional with 10+ years of experience in providing customer support to members and credentialing support for providers. Thorough knowledge of health care protocols, medical terminology, insurance products, and medical information systems. Loyal and dedicated individual who has the ambition to succeed in a wide variety of medical settings by utilizing office administration experience. Excellent customer service skills. Completing coursework toward becoming a Certified Medical Administrative Assistant to work as a back office assistant (scheduling, verifying insurance, obtaining referrals, being a team player).

4Exceptional Interpersonal and Communication Skills – Proficient in patient communication and customer service – maintaining relationships while interfacing positively with people from diverse backgrounds.

4Problem Solving – Proven ability to develop both creative and innovative customer service solutions to help teams with challenges. Multi-tasks and works well under pressure for improved team productivity.

4Work Ethic and Professionalism – Solid professional standards and an excellent record of dependability. Proficiency in maintaining HIPAA standards. Maintains focus on achieving bottom-line results while always ensuring strong customer satisfaction.

Education

National University San Diego, CA

Certified Medical Administrative Assistant (CMMA) Presently Attending

Professional Experience

American Specialty Health San Diego, CA

Supervisor – Medical Provider Credentialing 2015 – 2019

Supervised a team of 12 credentialing representatives who verify primary verification for credentialing and re-credentialing of providers. Efficiently liaise between all the internal departments and served as point of contact. Maintain and update knowledge when policies change or need to be restructured.

Interview new employees coming into the department and hired. Educated new employees with the companies HIPAA requirements and policies. Responsible for providing feedback for new and existing personnel, write and deliver reviews on a quarterly basis. Discuss issues with clients.

Review applications for credentialing through CAQH. Ensure all required information/ documentation for license type and category is included. Verify authenticity of documentation. Contact providers for missing data.

Proven ability in utilizing exceptional communication skills when handling multiple phone lines, busy office operations, supporting other employees, and ensuring an efficient and pleasant office operation.

Ensure that applications are properly verified and accurately uploaded from CAQH into the online database system.

Strictly monitor and report turnaround times for processing of credentials applications with continued focus on delivery of a high-quality product with the greatest efficiency in the least amount of time.

Coordinate credentialing audits in compliance with the managed care delegated credentialing contracts.

American Specialty Health San Diego, CA

Customer Service Supervisor / Member Service Rep 2010 – 2015

Ascertained the nature of the records information in the appropriate system. Provided answers to questions by following standard policies and procedures. Interacted in a positive, respectful manner, and established and maintained cooperative working relationships with internal and external customers and members.

Utilized customer service skills in troubleshooting and resolving problems. Addressed a wide range of reported issues. Maintained, organized, and generated monthly report of all customer service issues.

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