Jimillah Sibyl Reeves
Summary
Credentialing Manager with extensive knowledge in credentialing, healthcare regulations, and Joint Commission compliance. Delivered valuable contributions through a strong work ethic, adaptability, and exceptional interpersonal skills. Motivated to embrace new challenges and excel in independent work environments.
Overview
14
14
years of professional experience
7
7
years of post-secondary education
Work History
Customer Service (contract)
Myers EPS
08.2025 - 01.2026
- Respond to customer inquiries by phone, email, and provide accurate information about products and service appointments.
- Managed customer accounts by processing orders, returns, exchanges, refunds, and cancellations to ensure seamless transactions.
- Resolve complaints and issues by determining the cause, identifying solutions, and following up to ensure a positive outcome.
- Delivered friendly, professional service to enhance customer satisfaction and align with company objectives.
- Communicate with internal teams, such as sales or operations, to coordinate solutions and ensure excellent customer support.
- Maintained and updated customer records in company systems to support accurate service delivery and continuity.
Credential Specialist (contract)
Weill Cornell Medicine
01.2025 - 03.2025
- Oversaw, reviewed, mailed, scanned, and tracked outgoing applications for physician enrollment, recertification, and revalidation into government payers for full-time faculty.
- Compiled appointment enrollment packages for candidates, liaised with Office of Faculty Affairs and Medical Staff Office, and followed up to ensure timely submission of paperwork.
- Processed all faculty and non-faculty academic appointments, reappointments, promotions, and terminations within the Medical College and NYPH.
- Entered data accurately and processed enrollment applications in compliance with credentialing policies and procedures.
- Coordinates and tracks compliance with mandatory Medical College and Hospital requirements on Annual Health Assessments, Annual Hospital Training, annual Organizational Readiness, faculty development reviews and other regulatory requirements.
- Maintained the internal database and external web module database, updating physician info in Medicare, Medicaid, and non-contracted carriers, including approval info, demographic details, address changes, and disenrollment.
- Organized individual physician and departmental files to comply with credentialing policies and procedures, including initial and recredential applications and credential verifications.
- Followed up with plan representatives to check the status of enrollment applications and correct any errors.
- Supported team objectives by completing duties efficiently.
Provider Enrollment Specialist
CareWell Health Medical Center
12.2023 - 06.2024
- Process and manage enrollment applications for dental providers into health plans and networks.
- Track and follow up on enrollment status with insurance companies and government programs (Medicaid, Medicare).
- Ensure accurate completion of credentialing and re-credentialing processes per regulatory and payer requirements.
- Verify provider licensure, certifications, malpractice insurance, and background checks.
- Assist with onboarding new dental providers, including system access, documentation, and training coordination.
- Supervised the credentialing and privilege process to comply with regulatory and Joint Commission standards.
- Coordinated and maintained MSO governance documents, including medical staff bylaws, rules and regulations, and credentialing manual, to ensure compliance and clarity.
Office Manager (contract)
ComboCap
08.2023 - 12.2023
- Organized and managed daily office operations and office procedures ran efficiently as well as developing and implementing new policies and procedures while adhering to regulatory requirements.
- Provide administrative support to Executives and manage their calendars.
- Received, sent, prepared, managed, sorted, and checked all correspondence and packages to ensure timely delivery.
Senior Credentialing Specialist
Medusind
12.2022 - 08.2023
- Led credentialing specialist in MSO, reviewed and screened initial and reappointment applications for completeness and accuracy per TJC standards.
- Ensure accurate completion of credentialing and re-credentialing processes per regulatory and payer requirements.
- Verify provider licensure, certifications, malpractice insurance, and background checks.
- Conducted primary source verifications and validated documents to ensure accuracy of credentialing elements, enhancing compliance and reducing discrepancies.
- Analyzed and resolved discrepancies that hindered the credentialing and enrollment of practitioners.
- Process and manage enrollment applications for dental providers into health plans and networks.
- Communicated with dental offices to gather documents and resolve enrollment issues.
- Entered and updated provider application data into credentialing database to ensure accuracy and compliance.
- Prepared, issued, electronically tracked and follows-up on appropriate verifications for efficient, high-volume processing of the Practitioners applications in accordance with credentialing deadlines for Medical Executive Committee.
Credentialing Specialist (contract)
Medi-Centrix
10.2022 - 12.2022
- Under direction and supervision of Director of Payer Enrollment and Credentialing, coordinated, executed, and successfully enrolled new providers (Physicians and Allied Health) with all contracted commercial and governmental payers for credentialing and re-credentialing of applications.
- Maintained comprehensive knowledge of NCQA standards and state and federal regulations governing credentialing processes.
- Performed and collected primary source verification documentation for licensing, board certifications, proof of professional liability insurances NPDB and/or other sources.
- Maintained and re-attested CAQH profiles for each provider.
- Complete Medicare/Medicaid revalidations in a timely manner using PECOS for Medicare.
- Ensured timely maintenance of re-credentialed renewal certifications on file, meeting all designated deadlines.
- Followed up on outstanding credentialing and re-credentialing files, collaborating with management and executive levels.
- Prepared credential committee grids and any adverse action documentation for review by Director of Payer Enrollment.
- Processed Physician and Allied Health terminations, specialty/category changes, leave of absence requests.
Human Resources Coordinator (contract)
Atlantic Health System
03.2022 - 08.2022
- Provided holistic case management services as the point of contact for assigned team members, reviewing medical documentation to adjudicate leaves in compliance with corresponding leave plans, federal and state laws, and benefit plans defined by Atlantic Health System.
- Initiated and responded to inquiries regarding leave, worker's compensation, disability events, benefits, and options for team members.
- Monitored, tracked, and maintained records for work-related injuries and absences, preparing periodic reports on safety, related absences, and modified duty data.
- Gathered timely information on team members sustaining work-related injuries/illnesses, identifying potential red flag issues and alerting management promptly.
Provider Enrollment Specialist
Eastern Dental Management
06.2021 - 02.2022
- Process and manage enrollment applications for dental providers into health plans and networks.
- Maintain up-to-date records of dental providers in internal systems and databases.
- Tracked and followed up on enrollment statuses with insurance companies and government programs, ensuring providers met participation deadlines.
- Ensure accurate completion of credentialing and re-credentialing processes per regulatory and payer requirements.
- Maintained dentist credentials to ensure compliance with initial and ongoing enrollment requirements for insurance plans.
- Conducted verification of provider licensure, certifications, malpractice insurance, and background checks to ensure compliance with industry standards.
- Completed applications for dental providers to facilitate enrollment.
- Updated and maintained Credential Stream and CAQH databases for accurate provider information.
Credentialing Specialist
Saint Clare's Hospital
05.2018 - 04.2020
- Executed credentialing for initial applicants and recredentialing for current applicants every two years within our facility.
- Verified that healthcare professionals such as: Physicians, Physician Assistants, Nurse Practitioners etc. are complying and following with the state and federal standards before granting them privileges.
- Verified the legitimacy of practitioners' information with universities, licensing agencies, Board certification groups.
- Coordinated with Provider Relations, Credentialing, and Claims to enhance enrollment workflows.
- Set up and maintain provider information is accurate, track reports of DEA, State Licensing, Malpractice Insurance, CDS licensing, and certifications in an online database system MD Staff.
- Prepared and maintained credentialing activity reports, including accreditation, membership, and facility privileges.
- Coordinated onboarding for new dental providers, including system access, documentation, and training.
Human Resource Specialist
Accountable Healthcare Staffing
02.2018 - 10.2018
- Facilitated recruitment processes for healthcare staffing needs across various specialties.
- Managed employee onboarding procedures to ensure compliance with company policies.
- Coordinated training sessions to enhance staff skills and regulatory knowledge.
- Verified up-to-date documents for health care providers, including license, ACLS, and CPR/BLS, then submitted staff profiles to clients to fulfill orders for LPNs, RNs, and CNAs.
- Converted health care professionals into active clients by establishing relationships and addressing needs.
Credentialing Specialist
Saint Peter's University Hospital
03.2012 - 01.2018
- Processed and managed enrollment applications for dental providers into health plans and networks, ensuring compliance with guidelines.
- Verify provider licensure, certifications, malpractice insurance, and background checks.
- Assist with onboarding new dental providers, including system access, documentation, and training coordination.
- Maintain up-to-date records of dental providers in internal systems and databases.
- Ran various reports to monitor active physicians' licenses, DEA, CDS, Privileges, Malpractice Insurance, and other documents based off JACHO guidelines.
- Developed and maintained comprehensive reports within MD Staff system to track departmental activities.
- Reported weekly with Director and Staff weekly for status updates on new applicants and reappointed applicants for the Medical Executive committee and for the Board Members to give final approval.
- Executed compliance tasks with regulatory and accrediting organizations and hospitals.
Education
BBA - Business Administration
Strayer University
Catasauqua, PA 06.2019 - 06.2026
Skills
- Customer support
- Healthcare software knowledge
- Data entry
- Basic data management
- Organizational communication
- Project management
- Regulatory compliance
- Problem resolution
- Time management
- Written communication
- Team collaboration
- Multitasking Abilities
- Organizational skills
- Team support
- Customer documentation
- Relationship building
- Project planning
- Software proficiency
- Effective communication
- Written communication
- Time organization
- Telephone etiquette
- Telephone etiquette
Timeline
Customer Service (contract)
Myers EPS
08.2025 - 01.2026
Credential Specialist (contract)
Weill Cornell Medicine
01.2025 - 03.2025
Provider Enrollment Specialist
CareWell Health Medical Center
12.2023 - 06.2024
Office Manager (contract)
ComboCap
08.2023 - 12.2023
Senior Credentialing Specialist
Medusind
12.2022 - 08.2023
Credentialing Specialist (contract)
Medi-Centrix
10.2022 - 12.2022
Human Resources Coordinator (contract)
Atlantic Health System
03.2022 - 08.2022
Provider Enrollment Specialist
Eastern Dental Management
06.2021 - 02.2022
BBA - Business Administration
Strayer University
06.2019 - 06.2026
Credentialing Specialist
Saint Clare's Hospital
05.2018 - 04.2020
Human Resource Specialist
Accountable Healthcare Staffing
02.2018 - 10.2018
Credentialing Specialist
Saint Peter's University Hospital
03.2012 - 01.2018