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| Desired Industry: Healthcare |
SpiderID: 7311 |
| Desired Job Location: Chicago, Illinois |
Date Posted: 5/30/2006 |
| Type of Position: Full-Time Permanent |
Availability Date: 6-1-06 |
| Desired Wage: 33,000 |
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U.S. Work Authorization: Yes |
| Job Level: Experienced with over 2 years experience |
Willing to Travel: Yes, 50-75% |
| Highest Degree Attained: High School/Equivalent |
Willing to Relocate: No |
Objective:
To obtain a position offering opportunity to utilize and enhance my professional skills with room for advancement.
Experience:
EXPERIENCE
2004-Present
St. Margaret Mercy Hospital
Dyer, IN
Credentialing Specialist
Secure qualified practitioners to render and administer the care of MCO members. Enroll employed physicians and service locations with contracted health plans (34) cognizant of HIPAA/NCQA standards. Develop contact rapports/mechanisms with payors, office managers and executive officials to meet and exceed enrollment requirements. Systematize manuscript and computerized files in a timely manner. Provide monthly reports for clinics and operations meetings; documentation to health plans to add, modernize or terminate contracts. Preserve accuracy of database. Encompass licensure, training, education and malpractice information requesting records from governmental parties as necessary with exclusive dedication to superior customer service.
2000-2003
Mt. Sinai Hospital/Sinai Medical Group
Chicago, IL
Credentialing Coordinator
Support needs for public and private clients, physicians, and staff executives. Managed physician profiles and state applications for submission and follow-up to PPO/HMO, IDPA, Medicare/Medicaid, and Health Plans. Developed, delivered, and produced information regarding managed care data. Improved department’s productivity by Credentialing (256 providers) with 32 individual Health Plans.
1999-2000
Unicare Health Plans
Chicago, IL
Credentialing Associate
Evaluated providers for participation within the networks of Wellpoint. Created files assessing state applications from 112 entities/hospitals. Furnished full background checks of all State Licenses, sanctions, and medical malpractice history. Examined confidential records/statements into itemized reports. Exceeded minimum requirements Credentialing over 75 files per committee. Trained new employees on protocol and department procedure.
1998-1999
Blue Cross and Blue Shield (Temp.)
Chicago, IL
Provider Relations Representative
Educated, serviced, and supported the needs of physicians, providers and practice managers. Handled associate consultants regarding claim discrepancies. Processed enrollment adjusting internal receivables utilizing Microsoft Office. Conveyed consistency with extensive record keeping, while also handling projects voluntarily and upon request.
1995-1999
Chicago Department of Health
Chicago, IL
Asst. Case Manager
Responsible for coordinating initial and follow-up appointments for new admissions and at risk patients. Conducted home and physician office site visits. Maintained all billing. Assisted group members through the help desk locating organizational services. Systemized individual and group conferences for several departmental managers.
Education:
EDUCATION
Wilberforce University - Computer Science/Business Admin. GPA 3.8
Affiliations:
Active member in good standing of NAMSS (National Association Medical Staff Services).
Additional Information:
Jasmine J. Davis
Calumet City, IL 60409
Home: 708-360-6218
Cell: 708-704-6340
Re: Employment Opportunities
To Whom It May Concern:,
I have over ten years of advanced administrative support experience in healthcare administration, initially as an Assistant Case Manager for the Chicago Department of Health. My profession entails working both the private and public sectors, along with all levels of management. My superb understanding of Microsoft Office and its components has proven to be an asset to me in all areas of Administrative, Billing, and Operational services.
My primary duties have included but are not limited to: responding effectively to complaints and inquiries; drafting, editing and proofing correspondence, reports, minutes, ordinances and other documents. I possess an intense level of integrity and diplomacy in dealing with highly confidential medical, legal, ethical and financial issues demonstrating strong analytical skills and extreme dedication to superior customer service. Producing excellent verbal and writing skills has allowed me to function complex liaisons (presentations, negotiations, etc.) with clients and colleagues at many levels. I am self-directed in determining priorities and optimizing time to maximize productivity. Proper training has given me the ability to: team lead, react quickly and professionally to demanding situations, coordinate special projects, establish/maintain valuable client and internal relationships, and possess a firm reputation for upholding ethical standards in realizing company goals and objectives. Lastly, I am an active member in good standing with NAMSS (National Association Medical Staff Services), a preeminent international organization committed to the delivery of quality health care by the professional development of individuals responsible for managing credentialing, privileging, practitioner/provider organizations, and regulatory compliance in the diverse healthcare industry.
My sincere desire is to associate myself with a position that demands and rewards excellence while providing long term opportunities for personal growth and advancement. It would be my pleasure to meet and discuss the opportunity you have available and assess if my credentials exemplify your qualifications. I believe I would make a positive contribution as an asset within this role.
Thank you for your consideration.
Sincerely,
Jasmine J. Davis
jd
Reference:
Valerie Johnson 708-757-1972
Candidate Contact Information:
| Name: Jasmine Davis |
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| Street: - |
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| City: Chicago |
Fax: - |
| State: Illinois |
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| Zip: - |
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