DaJya Jackson
Raleigh,US
Summary
Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills.
Overview
7
7
years of professional experience
Work History
Prevention Wellness Coordinator
CVS Health
01.2022 - Current
- Empower and promote preventative health strategies and cost-effective, evidence-based care for over 200,000 patients.
- Act as strategic partner and forge professional relationships among organizational and community stakeholders, including the AZ Legislature, Population Health Alliance (PHA), Arizona Public Health Association (AzPHA), Arizona Department of Health.
- Played key role of data analyst in implementing complex data sets, establishing performance improvement initiatives, and utilizing deliverables to drive continuous growth and diversification
- Audited medical providers, ensuring compliance with AHCCCS standards.
- Spearheaded various projects, designing, editing, and publishing portions of the Mercy Care 2022–2023 Member Handbook, provider manual, educational materials, and notifications, focusing on care standards and compliance.
Credentialing Specialist
Duke Health
01.2019 - 02.2022
- Received and evaluated applications to look for missing and inaccurate information.
- Conducted primary source verifications such as background checks and board certifications.
- Prepared records for site visits and file audits.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Partnered with departmental managers to ascertain hiring needs and subsequently provide candidate recommendations.
Pharmacy Assistant
St. Joseph Mercy Hospital
01.2018 - 01.2019
- Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
- Counted and labeled prescriptions with correct item and quantity.
- Communicated instructions to patients or caregivers about proper use and storage of drugs.
Credentialing Coordinator
Somatus
01.2017 - 01.2018
- Tracked expiration dates on documents and communicated with appropriate staff to avoid late filing.
- Communicated effectively with various parties each day using polished interpersonal and active listening skills.
- Worked closely with practitioners to help each obtain privileges at assigned healthcare facilities
- Assisted with managed care auditing processes and performed internal file audits.
- Maintained accurate files, records and credentialing documents in well-maintained databases using software.
Education
Bachelor of Science - Public Health
Eastern Michigan University
Skills
- Detail Oriented
- Computer Literacy (Microsoft Word, Excel, PowerPoint)
- Organized
- Communication Skills
- Collaboration
- Managed Care
- Databases
- Compliance
- Provider enrollment
- Accreditation information management
- Provider Relations
Timeline
Prevention Wellness Coordinator
CVS Health
01.2022 - Current
Credentialing Specialist
Duke Health
01.2019 - 02.2022
Pharmacy Assistant
St. Joseph Mercy Hospital
01.2018 - 01.2019
Credentialing Coordinator
Somatus
01.2017 - 01.2018
Bachelor of Science - Public Health
Eastern Michigan University