Summary
Overview
Work History
Education
Skills
Software
Interests
Timeline
Generic

Cameshia Jones

Avenel,New Jersey

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.

Overview

8
8
years of professional experience

Work History

Provider Data Analyst

Enlyte|Mitchell|Genex,|Conventry
01.2021 - 05.2024
  • 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.

Credentialing Analyst

Qualcare|Cigna Healhcare|insurance Company
06.2019 - 01.2021
  • 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.

Quality Assurance Analyst

Logistacare Solutions, LLC
05.2016 - 01.2018
  • 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

Medical|Business - Medical Business

Hunter Business School
3601 Hempstead Tpke, Levittown NY 11756
03-2007

Skills

  • Healthcare Data Privacy Expertise
  • Data cleaning
  • Data engineering
  • Power BI proficiency
  • Healthcare industry
  • Data validation

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

Timeline

Provider Data Analyst

Enlyte|Mitchell|Genex,|Conventry
01.2021 - 05.2024

Credentialing Analyst

Qualcare|Cigna Healhcare|insurance Company
06.2019 - 01.2021

Quality Assurance Analyst

Logistacare Solutions, LLC
05.2016 - 01.2018

Medical|Business - Medical Business

Hunter Business School

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Cameshia Jones