Provider Data Power Bi

CAMESHIA JONES

Avenel, New Jersey *****

732-***-**** - ***************@*****.***

PROFESSIONAL SUMMARY

Adept in healthcare data privacy and data engineering, I spearheaded initiatives at Enlyte Mitchell Genex Conventry that positioned us as industry leaders. My proficiency in Power BI and collaborative approach enhanced cross-functional integration and compliance, showcasing my ability to innovate and maintain stringent data accuracy. Knowledgeable [Desired Position] with solid background in analyzing and managing provider data. Possesses valuable experience enhancing data accuracy and streamlining processes for better efficiency. Demonstrated proficiency in data management and problem-solving through collaborative efforts and adaptability to changing needs. SKILLS

●Healthcare Data Privacy Expertise ●Data cleaning

●Data engineering ●Power BI proficiency

●Healthcare industry ●Data validation

WORK HISTORY

01/2021 to 05/2024 Provider Data Analyst

Enlyte Mitchell Genex, Conventry – 9771 Clairemont Mesa Blvd, Ste A, San Diego CA

●Implemented robust security measures, safeguarding sensitive information while working with confidential datasets containing proprietary industry knowledge.

●Collaborated with cross-functional teams to ensure seamless integration of provider data across multiple platforms.

●Maintained compliance with industry regulations by ensuring accurate documentation and reporting of all relevant provider information.

●Spearheaded the development of new methodologies for analyzing provider data, positioning the organization as a leader in its field.

●Updating provider physican demographics, address, npi, license and current insurances they will accept in and out of network as well as workers comp.

●Verifying providers current eligibility to practice as well as the type of insurance they will comply with.

●Maintaining and updating private practice, facilities and hospitals in and out of network. Maintaining daily providers facility hospitals credentials, demographics and current practice status.

●Working in a queue daily and including 1-400+ providers facilities and hospitals and their requirements as well as regular projects assigned while completing daily tasks.

●Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.

●Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients. 06/2019 to 01/2021 Credentialing Analyst

Qualcare Cigna Healhcare insurance Company – 30 Knightsbridge Road, Piscataway NJ 08854

●Troubleshot issues with electronic applications, quickly identifying problems and implementing solutions to maintain workflow efficiency.

●Ensured accuracy in data entry by carefully reviewing applicant information before inputting it into the system.

●Facilitated strong relationships between providers and facilities through effective communication and coordination during the credentialing process.

●Completed comprehensive background checks, ensuring all candidates met company standards for quality care provision.

●Enhanced department productivity with proper organization and timely completion of tasks.

●Streamlined the credentialing process by implementing efficient tracking systems and maintaining accurate records.

●Managed strict deadlines effectively, prioritizing tasks and efficiently allocating resources to ensure optimal productivity.

●Assisted in maintaining an updated database of credentialed providers, allowing for quick access to essential information when needed by senior management or other departments within the organization.

05/2016 to 01/2018 Quality Assurance Analyst

Logistacare Solutions, LLC – 37-18 Northern Blvd, Long Island City NY 11101

●Mentored and coached team members on QA topics and strategies.

●Participated in regular meetings with cross-functional teams to discuss progress updates, communicate concerns or challenges, and ensure alignment of project goals.

●Reported progress, test metrics and results to project stakeholders.

●Maintained comprehensive knowledge of relevant industry regulations and standards, ensuring compliance throughout the QA process.

●Streamlined QA processes for increased efficiency and reduced time spent on redundant tasks.

●Acted as a liaison between the QA team and other departments such as Development, Customer Support, and Product Management, ensuring effective communication throughout all stages of the project lifecycle.

●Reduced defect rates through meticulous attention to detail during code reviews, working closely with developers to address any identified issues quickly.

●Championed quality assurance initiatives within the organization by promoting a culture of continuous improvement and striving for excellence in all aspects of product development.

●Gathering all and necessary information in a report for management review before it goes to the state of New York.

EDUCATION

03/2007 Medical Business: Medical Business

Hunter Business School - 3601 Hempstead Tpke, Levittown NY 11756 SOFTWARE

Micofoft word, excel, access, outlook

nipples, meditrac, uniflow

INTERESTS

●Enjoy participating in [activity] for overall physical and mental well-being.

●I participate in low-impact exercises to strengthen core muscles.

●Team Sports

●Gym Workouts

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