Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jane Williams

Philadelphia,PA

Summary

  • Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills.
  • Multitasking professional skilled in file efficiency and database integrity. A resourceful Credentialing Coordinator with a background in tracking the expiration of practitioner documents.
  • To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
  • Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

23
23
years of professional experience

Work History

Credentialing Coordinator

Health Partners Plans
09.2020 - 04.2023

Working under general supervision responsible for initiating the credentialing process of practitioners application through CAQH Proview.This includes initial review of the application, data entry into the credentialing database, primary source verifications, verbal and written follow up with the practitioner and final review of the application

Lead Client Service Representative

Independence Blue Cross
Philadelphia, PA
07.2000 - 08.2018
  • Utilized active listening skills to identify customer needs and provide appropriate solutions for Providers claims and billing
  • Reduced process inconsistencies and effectively trained team members on best practices and protocols.
  • Responded proactively and positively to rapid change.
  • Collaborated with other departments to develop ways to increase customer satisfaction.
  • Investigated and resolved customer inquiries and complaints quickly.
  • Increased efficiency and team productivity by promoting operational best practices.
  • Coordinated with operations staff to resolve service problems and boost client satisfaction.
  • Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
  • Cross-trained and provided backup support for organizational leadership.

Education

High School Diploma -

Simon Gratz
Philadelphia, PA
06.1986

Skills

  • Data Research and Analysis
  • Provider Enrollment
  • Credentialing Data Coordination
  • Re-Credentialing Processes
  • Office Operations
  • Credential Verification
  • Credentialing Documentation
  • Community Health Center Credentialing
  • Effective Written and Verbal Communication
  • Efficient in PSV,CAQH,DOH Surveys, Initial Credentialing and Re-Credentialing for Individual providers,ancillaries and facilities
  • Credentialing Policies
  • Accreditation Information Management
  • Database Maintenance

Timeline

Credentialing Coordinator

Health Partners Plans
09.2020 - 04.2023

Lead Client Service Representative

Independence Blue Cross
07.2000 - 08.2018

High School Diploma -

Simon Gratz
Jane Williams