Operations & Quality Improvement Leader

Arylin Diann Jenkins, CPCS-R, MA, MS

Lilburn, Georgia

*************@*****.***

Mobile: 205-***-****

SUMMARY

Reliable, goal-oriented leader with extensive experience across various stations and industries with proven success in enhancing process efficiency, profitability, and customer service through comprehensive operational analysis and deployment of systems. A collaborative, servant leader who embodies the business acumen to yield effective communication, systematic organization, and utmost accountability to ensure positive impacts.

HIGHLIGHTS OF QUALIFICATIONS

Strategic Planning & Implementation · Quality System Development · Compliance & Regulations · Research & Development · Risk Assessment/Management · Relationship Management · Operations Analysis/Process Redesign · Public Relations & Communications · Budget Optimization · Quality Clinical · Quality Management System · Problem Resolution & Performance Improvement/Root Cause Analysis · Internal/External Auditing · CPCS-R, NAMSS

EXPERIENCE

Genpact, LLC, Sandy Springs, GA Oct 2022 – Present

Issue Resolution Specialist

Support the Professional Services Firm Issue Management Division with a focus on serving as a resource and liaison between key stakeholders while ensuring compliance with service-level agreements and internal policies

Manage the customer service and issue resolution experience for three key clients (State Auto, American Family Insurance and USAA)

Resourcefully review, evaluate, and investigate each claim by analyzing data to drive decision making and determine appropriate case resolutions

Prioritize the customer experience by following the complaint throughout the full case cycle while servicing as the point of contact between contractors, customers and the insurance company while maintaining full documentation of all encounters

Independently interview customers/contractors to obtain pertinent facts and leverage the information to determine loss facts and coverage for claims; assess mitigation handling on a claim-by-claim basis

Optimize communication across stakeholders, customers, contractors, emergency repair services, cleaning services, and adjusters to create policy and procedure alignment for handling losses as per regulatory requirements

National Integrated Health Group (NIHC Group), Dallas, TX June 2021 – Oct 2022

Credentialing Analyst

Maintained compliance with all regulatory and accrediting institutions; maintained proper records of licenses, credentials, and insurance contracts

Monitored staff credentials and licenses; advised and assisted on renewal procedures

Maintained compliance with all regulatory and accrediting institutions in the country

Released information to agencies and members of the public as required by law, and ensured data was protected, secured, and up to date

Developed quality relationships with payer sources.

Provided end-to-end services such as initial credentialing, re-credentialing, notification of expiring documents and maintaining CAQH Profile

Sykes Work at Home Enterprises, Tuscaloosa, AL May 2017 – June 2021

Customer Care Professional

Helped customers by answering account-related questions and resolving issues with utilization of CRM systems

Deployed customer service systems to record, empathize, and identify solutions to issue or source of discontent

Collaborated with all stakeholders for issue resolution

Department of Veteran Affairs

Central Alabama Veterans Health Care System, Montgomery, AL Oct 2006 – Dec 2012

Program Support Assistant

Assumed overall coordination of the credentialing and privileging for appointment, reappointment, special advancement for performance/achievement, and change in status of appointment processes for all full-time and part-time staff physicians, consulting and attending staff, fee basis, without compensation (WOC), contract, and all regular licensed independent practitioners to include dentists, psychologists, radiologists, gastroenterologists, surgeons, optometrists, podiatrist, physician assistants, certified registered nurse anesthetist, etc.

Worked with Human Resources as a member of the Human Resources Collaboration team to ensure that licensed independent practitioners were hired and brought on board in a timely manner.

Planned and conducted projects to improve the efficiency and productivity of the organization’s Medical Staff/Credentialing and Privileging Program

Processed current medical staff (over two hundred practitioners) for reappointment and clinical privileging according to VHA, VISN 7, CAVHCS, and JCAHO standards in a timely manner

Independently monitored the effectiveness of the agency’s Credentialing and Privileging program and developed new procedures or recommendations for policy change to augment the program’s effectiveness in meeting established goals and objectives

Provided program analysis and other evaluative materials and summaries essential to efficient planning, control, and direction of this health care system’s credentialing and privileged program

Responsible for control point activities, which include processing purchase order requests, reconciliations of transactions; running ad hoc reports and responding to logistical management audits using procedures outlined in the federal acquisition regulations, public laws, and agency policy

Collaborated with the Administrative Officers and Contracting Agencies to ensure credentialing requirements for Statement of Work {SOW) requests; ensured that the appropriate credentialing documents were submitted

Revised organizational policies and prepared responses for the Chief of Staff pertaining to Credentialing Issues for Quality Ad Hoc reports

Worked with Legal Counsel and other appropriate stakeholders regarding disciplinary credentialing actions for licensed independent practitioners

Westat Inc, Rockville, MD Dec 2005 – March 2006

Assessment Administrator

Disability Determination Services, Birmingham, AL Aug 2004 – Nov 2004

Disability Specialist

Atlanta Technical College, Atlanta, GA June 2002 – June 2003

Institutional Effectiveness Specialist

ADDITIONAL CREDENTIALING/HUMAN RESOURCES EXPERIENCE

Childrens’ Healthcare of Atlanta, Atlanta, GA Sept 2001 – April 2002

Credentialing Coordinator

Physicians Health Plan, Columbia, SC June 1997 – Aug 2001

Credentialing Supervisor (2000 – 2001)

Credentialing Liaison (1999 – 2000)

Senior Credentialing Coordinator (1998 – 1999)

Credentialing Coordinator (1997 – 1998)

Moncrief Army Community Hospital, Fort Jackson, SC Jan 1994 – June 1997

Secretary, Quality Improvement Department

Army & Air Force Exchange, Fort Jackson, SC Oct 1993 – Jan 1994

People Resource Representative

EDUCATION

Capella University, Minneapolis, MN

MS, Industrial & Organizational Psychology

Webster University, Fort Jackson, SC

MA, Human Resource Development, Cum Laude Graduate

University of Alabama, Tuscaloosa, AL

BS, Human Resource Management

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