Summary
Overview
Work History
Education
Skills
Awards Certificates
Timeline
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Ebony Nealey

Ebony Nealey

Loma Linda,CA

Summary

Being committed to providing the highest quality patient care, customer service representative and obtains an uncompromising approach to clinical and administrative excellence Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty. Experienced administrative professional with 3+ years in provider credentialing services. Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans.

Overview

11
11
years of professional experience

Work History

Credentialing Specialist

Imperial Health Holdings
05.2020 - 03.2023
  • Completes credentialing, re-credentialing and medical staff applications for clinical staff and submits information to commercial and government payers in timely manners
  • Ensures that all provider files are complete with current licensing and certification documents
  • When appropriate, works cooperatively with administrative staff to obtain pertinent information necessary for IPA's
  • Develops thorough understanding of credentialing terminology and documents and is able to utilize external systems used to research and obtain pertinent information
  • Responsible for reviewing and verifying all credentialing documentation for providers, confirming consistency and accuracy based on regulatory requirements.

Provider Services

OrthoNet LLC
  • Answering incoming calls from healthcare providers assisting with provider needs
  • Navigating through multiple systems application to identify current status
  • Assisting with information in a compassionate manner providing excellent customer service skills
  • Completing documentation necessary to track provider issues and concerns
  • Meeting performance expectation establishing for the position
  • Knowledge of healthcare protocols and providing great service for providers.

Nursing

JWCH Institute
  • Conducts triage for all walk-in patients; including vital signs and complete assessments
  • Conducts telephone triage via the Call-Center following the proper policies and procedures
  • Completes TB screenings/readings and documentation
  • Administers oral, IM, SC, and SL medications as needed
  • Patient flow deficiencies
  • Preparation and dispensing of all medications as ordered by the Provider; to include the completion of dispensed medication labels
  • Collaborates with the Clinic Administrator and assists with the continuing improvement of systematic functions.

Member Service Representative

Beacon Health Options
05.2016 - 06.2016
  • Managed provider data files and provider/member loads
  • Screening and registering members
  • Work Excel sheets for daily follow up
  • Performs a variety of clerical functions associated with patient accounts while keeping patient confidentiality and satisfaction as a priority
  • Participated on teams working on improvements to the quality systems and continuous improvement project
  • Has working knowledge of and ability to apply the principles of project management and performance improvement to ongoing initiatives.

Nursing

Pediatric Medical Center
02.2012 - 05.2013
  • Coordinated patient referrals with specialty practices
  • Screening Patients from MSR Call center for further assistance to PHS
  • Performed immunization administration and phlebotomy procedures for infants - 18 years of age
  • Maintained detailed inventory of vaccines; ordered pediatric vaccines and supplies for unit
  • Provide physician assistance with all patient care and procedures
  • Obtaining vital signs and chief complaint
  • Ensuring efficient patient flow, pulling and preparing charts, rooming patients
  • Perform clerical duties such as; answering phones, scheduling appointments, entering patient's information in the system.

Education

Associate of Science - Law (Pre-Law)

Riverside City College
Riverside, CA
12.2024

Healthcare

InfoTech Career College
Paramount, CA

Skills

  • Extremely organized office professional
  • Able to read and understand medical charts for Pain Management/ Surgery
  • Very strong communication skills
  • Will work as many hours per week as necessary
  • Demonstrated ability to analyze and recommend sustainable process changes
  • Profound knowledge and experience working health service providing facility
  • Remarkable ability to enter data accurately
  • Excellent listener with good verbal and written communication skills
  • Professional demeanor and excellent relationship building skills
  • Organized and ability to handle multiple tasks simultaneously and effectively
  • Strong attention to detail and follow up
  • Years of experience in hospital and managed care and organizational setting
  • Strong computer system knowledge eg SAP, Excel, Word, PowerPoint, Outlook
  • Knowledge of quality process and procedures
  • Existing knowledge of facility's clinical/operations processes, challenge's, and Med Tech environment
  • HIPAA Compliance
  • Facility support
  • Remote Conferencing and Communication
  • Microsoft Office
  • Documentation and Recordkeeping

Awards Certificates

  • Perfect Attendance
  • Honor Roll
  • Student Mentor
  • GPA 3.0
  • OSHA
  • HIPAA
  • CPR
  • First Aid

Timeline

Credentialing Specialist

Imperial Health Holdings
05.2020 - 03.2023

Member Service Representative

Beacon Health Options
05.2016 - 06.2016

Nursing

Pediatric Medical Center
02.2012 - 05.2013

Provider Services

OrthoNet LLC

Nursing

JWCH Institute

Associate of Science - Law (Pre-Law)

Riverside City College

Healthcare

InfoTech Career College

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Ebony Nealey