Summary
Overview
Work History
Education
Skills
Accomplishments
Knowledge Skills Qualifications
Affiliations
Work Availability
Work Preference
Software
Interests
Timeline
Hi, I’m

E. Shakirah El-Amin

Coordinator, Blue Cross Blue Shield of Michigan
Detroit,MI
E. Shakirah El-Amin

Summary

Experienced administrative professional with 16+ years in the health care industry, 9+ years in provider enrollments/credentialing services. Proficient in analyzing, planning, attention to detail, problem-solving, writing/reporting, and customer service to achieve better business outcomes at the strategic, tactical, and operational level. Proficient in Microsoft Suite (Excel, Outlook, PowerPoint, Access, Word, and etc). Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans.

Overview

18
years of professional experience

Work History

Blue Cross Blue Shield of Michigan

Credentialing Coordinator
06.2021 - Current

Job overview

  • Successfully completed practitioner and provider reports for credentialing and recredentialing based on State and Federal regulations and NCQA accreditation standards
  • Request primary source documentation for overall case categorization to report findings to the Medical Director and Enterprise Credentialing Committee
  • Proficient Skills: Case Management, Prioritization, MS Office Suite, and CAQH
  • Leadership Roles: Process Improvement Workgroup: This team meets with the purpose of improving CCPS procedures, looking at best practices and collaboration with other departments
  • Trained CCPS team to ensure signatures and dates on all documents to guarantee positive uniformity
  • As a result, received a positive NCQA audit outcome
  • Lead the alignment of Portico tools to aid locating credentialing contacts
  • Diversity and Inclusion Team Member

Blue Cross Blue Shield of Michigan

Provider Enrollment Service Representative
03.2015 - 06.2021

Job overview

  • Efficiently handled Provider/Practitioner/Facility Enrollment application inquires
  • Skillfully monitored provider issues to identify, address, and analyze concerns
  • Provided training tools to expedite servicing models and educational solutions
  • Achieved year over year 100% Quality and Performance reviews
  • Proficient: Portico, MACESS, CAQH, BCBSM NPI Crosswalk, MCGs/PHOs, Self-Service tool

Blue Cross Blue Shield of Michigan

BCN Customer Service Representative II
03.2008 - 02.2015

Job overview

  • Investigate/resolve caller inquiries regarding claim; authorizations; medical & pharmacy benefits; eligibility; updates & changes in FACETS
  • Educated callers concerning policies and procedures
  • Utilized the MACESS (workflow tracking system), to record details of the inquiry and request update for the appropriate files
  • Verified/updated pharmacy profiles via the Express Scripts Benefit Manager
  • Proficient Skills: FACETS, MACESS, BCN Provider Crosswalk, and CareAdvance

First Investors Corporation

Financial Service Representative
04.2006 - 02.2007

Job overview

  • Helped clients accumulate wealth; maximize return on retirement and non-retirement accounts; performed retirement, educational savings, and life insurance needs analysis based on financial statements review.

Education

Villanova University

Certification in Business Analytics

University Overview

Western Michigan University

Bachelors Business Administration from Computer Information Systems

University Overview

University of Arizona Global Campus

Master of Science from Health Informatics & Analytics
01.2025

University Overview

Skills

  • Root Cause Analysis
  • Statistical Inference
  • Case Management
  • Process Improvement
  • Project Management
  • SAS/SQL
  • Data research and analysis
  • Effective written and verbal communication
  • Background Investigations
  • Re-credentialing processes
  • Records and file management
  • Professional Networking
  • HIPAA Compliance
  • Issue identification and resolution
  • Documentation workflows
  • Practitioner application monitoring
  • Database Maintenance
  • Regulatory Compliance

Accomplishments

Accomplishments

Lead Presenter for Department Process Improvement Workgroup

  • Identify and implement best practices refreshers

Credentialing Exceed rate

  • 40% for case closes to departmental goals
  • 27% for case standard processing time.

Knowledge Skills Qualifications

Knowledge Skills Qualifications
  • Organizational skills to lead, train, and assist teams in business analysis efforts for projects.
  • Effective interpersonal skills, ability to interface with employees through the enterprise.
  • Past Financial Service Representative - NASD Series 6, 63, & Michigan Life Insurance Licenses.
  • Plan and conduct elicitation activities and confirm the results.
  • Describe how to manage and maintain requirements and design information from inception to retirement. Define user stories.
  • Identify the business need/problem, address that need, and align the change strategy within the enterprise.
  • Organize requirements, specify, model designs, validate and verify information, identify solution options, and translate the potential value that could be realized.
  • Examine the performance and value delivered by a solution. Recommend improvements on increasing values.
  • Agile methodologies – flexible mindset with the ability to prioritize the objectives. Can apply various Agile tools, knowledge of Scrum, to teach team roles and processes.

Affiliations

Affiliations

BCBSM Leadership Development Association (LDA) - Chapter 141

Availability
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sunday
morning
afternoon
evening
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Work Preference

Work Type

Full Time

Location Preference

RemoteHybrid

Important To Me

Flexible work hoursWork from home optionPersonal development programsWork-life balanceCareer advancement401k matchPaid time offHealthcare benefitsPaid sick leaveStock Options / Equity / Profit SharingCompany Culture

Software

Microsoft Office

CRM

Zoom

Facets

Portico

SQL

Data Visualization

Excel

Access

Word

Outlook

PowerPoint

Google Docs

Interests

Crafting

Volunteering

Fundraising

Marketing

Sales

Agile Methodologies

SCRUM

Budgeting

Event Planning

Timeline

Credentialing Coordinator
Blue Cross Blue Shield of Michigan
06.2021 - Current
Provider Enrollment Service Representative
Blue Cross Blue Shield of Michigan
03.2015 - 06.2021
BCN Customer Service Representative II
Blue Cross Blue Shield of Michigan
03.2008 - 02.2015
Financial Service Representative
First Investors Corporation
04.2006 - 02.2007
Villanova University
Certification in Business Analytics
Western Michigan University
Bachelors Business Administration from Computer Information Systems
University of Arizona Global Campus
Master of Science from Health Informatics & Analytics

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E. Shakirah El-AminCoordinator, Blue Cross Blue Shield of Michigan