Comfort Olundegun
Houston,TX
Summary
Dynamic Credentialing Specialist with proven expertise at KPS Life in managing provider credentialing processes and ensuring compliance with healthcare regulations. Recognized for meticulous record-keeping and exceptional communication skills, I effectively coordinated with cross-functional teams to enhance operational efficiency and uphold accreditation standards. Proficient in credentialing software and database management.
Overview
6
6
years of professional experience
Work History
Credentialing Specialist
KPS Life
01.2022 - Current
- Managed comprehensive provider credentialing, including application review, verification, and maintenance of files.
- Ensured adherence to state regulations and accreditation requirements throughout the credentialing process.
- Performed extensive primary source verification for medical staff credentials and work history.
- Coordinated with Human Resources and Legal to guarantee timely submission of necessary documents.
- Acted as intermediary between healthcare providers and insurers for network enrollment compliance.
- Maintained up-to-date databases to ensure confidentiality and integrity of provider records.
- Engaged in internal audits, executing corrective measures for any credentialing discrepancies.
- Supported development of credentialing policies reflecting current industry standards.
Claim Agent
Foundever LLC
06.2020 - 09.2022
- Functioned as main contact for inbound customer service inquiries at first and second levels.
- Ensured first-contact resolution by utilizing proper procedures and documented resources, supporting policyholder retention.
- Captured essential business and customer interaction details for Agent follow-up.
- Explored customer needs during interactions, forwarding relevant information to licensed teams as needed.
- Implemented underwriting guidelines to accurately process additional or replacement policy requests.
- Addressed routine inquiries about payments, insurance proofs, and identity verifications efficiently.
- Escalated complex issues or inquiries as necessary to the appropriate channels.
- Communicated coverage options clearly, enhancing understanding for existing customers.
Education
Bachelor of Science - Computer Science
University of Lagos
Lagos State01-2014
Skills
- Management of credentialing processes
- Understanding healthcare regulations
- Standards for accreditation
- Detail-oriented record keeping
- Communication skills
- Organizational expertise
- Time management proficiency
- Expertise in credentialing software
- Database management capabilities
Timeline
Credentialing Specialist
KPS Life
01.2022 - Current
Claim Agent
Foundever LLC
06.2020 - 09.2022
Bachelor of Science - Computer Science
University of Lagos