LAURETTA IKEM
Dallas ,TX
Summary
Experienced professional with a strong background in Healthcare billing and revenue cycle management , provider enrollment, data entry, and customer service. With a solid foundation in managing workflow systems, conducting quality checks, and ensuring accurate classification of applications . Proven ability to coach providers through the enrollment process and actively participate in fraud detection and prevention efforts.
I have a near perfect customer service , time management and office technology skills resulting unparalleled customer / patients satisfaction. Highly skilled in resolving claim denials , account reconciliations and ensuring compliance with billing standards . proficient in utilizing tools like Word, Excel, and PowerPoint. Adept in EMR systems and management software such as Epic and Cerner.
Overview
9
9
years of professional experience
Work History
Provider Enrollment Analyst
Palmetto Gba - Broadpath Llc
03.2025 - 03.2026
- Prescreened, verified and enrolled over 200 provider enrollment applications per month for Medicare, Medicaid, Blue Cross, Blue Shield, various states.
- Analyzed provider enrollment applications for accuracy and compliance with regulatory guidelines.
- Facilitated onboarding processes for new healthcare providers, ensuring timely and efficient enrollment.
- Managed both individual and group enrollments, including new TINs and new service locations
- Enrolled and approved new enrollment and revalidation applications through PECOS, CAQH, and payer portals, ensuring 100% compliance with payer requirements.
- Ensured timely completion of enrollment applications by closely monitoring deadlines and prioritizing tasks accordingly.
- Reduced errors in provider enrollments with meticulous attention to detail during application reviews and follow-ups when necessary.
- Made contact with providers / contact person to obtain addition information when needed.
- Performed license and background verification for each provider application using tools like PowerBi, Sam &OIG.
Provider Enrollment Analyst
CGS Administrative - Broadpath Llc
01.2024 - 02.2025
- Analyzed enrollment data and trends to identify opportunities for process improvement and efficiency enhancements for improvement.
- Reduced errors in provider enrollments with meticulous attention to detail during application reviews and follow-ups when necessary.
- Provided training and support to new employees , team members on enrollment procedures, policies, and systems.
- Maintained strict confidentiality standards, ensuring sensitive provider data was handled with the utmost care and discretion.
- Uphold a high level of customer service while interacting with providers, fostering trust and confidence in our organization''s capabilities.
- Effectively managed multiple priorities, successfully meeting tight deadlines while maintaining high-quality work standards.
- Obtained information from internal department, providers, government and/or private agencies, etc. to resolve discrepancies/problems.
- Collected, updated and maintained necessary provider information and documentation and verified the information where possible.
- Established and maintained data entry in CAQH.
- Prepared credentialing applications for all initial applications and reappointment in a timely and complete manner.
- Performed analysis and appropriate follow-up of each initial application and reappointment.
- Adhered to department policies and procedures including timely delivery of completed work and use of resources.
- Responsible for entering, updating, maintaining NPI and any other applicable provider numbers.
- Provided concise, timely communication to appropriate leadership regarding potential credentialing issues.
- Managed over 50 incoming calls, emails and faxes weekly.
Revenue Cycle Specialist
Accenture Health
01.2022 - 12.2023
- Increased revenue by identifying and resolving billing errors in a timely manner.
- Checked claim status/ submit eligibility inquiries using Waystar/Availity .
- Ensured accurate billing with thorough audits of patient accounts and insurance claims.
- Contacted patients to address missing or incorrect claim information, such as member ID.
- Reviewed , analyzed and resolved complex claims issues and payer behavior using billing systems, payor portals and EOB reviews .
- Identified and resolved payment issues between patients and providers.
- Adhered to legal and ethical guidelines of HIPAA for safeguarding patient and company confidential information .
- Posted payments to collection accounts/ reconciled posted bank transactions. Also collaborated with AP department to have refund issued when needed.
- Maintained productivity goals and metrics set by the department.
- Reviewed and appealed denied and unpaid claims .
Data Entry/Provider Enrollment Specialist
Star Pediatric (Remote)
12.2020 - 12.2021
- Handled 50+ calls daily
- Dealt and Assisted patients and their families through remote communication channels, such as phone and online chat, ensuring they received accurate information and guidance
- Provided exceptional customer service by addressing patient inquiries, concerns, and requests promptly and professionally
- Scheduled and managed remote appointments coordinated patient check-in and check-out processes and verified patient insurance information
- Offered remote billing assistance, explained payment options, and assisted with insurance-related questions, ensuring a smooth patient experience.
- Completed enrollment of all providers timely and accurately. Consistently maintained effective processes for monitoring provider enrollment status for all payer funding sources.
- Maintained production requirements determined by Manager.
- Served as the primary contact for Provider Enrollment claim denials with payors, SCP Medical Collections, Revenue Integrity, Systems, and Managed Care departments
- Acted as a remote liaison between patients and medical staff, facilitating clear and effective communication
- Collaborated with hospital personnel and resolved patient concerns and issues while working remotely
- Maintained and updated patient records with meticulous attention to detail, ensuring data accuracy and confidentiality
- Participated in virtual training programs to stay updated on hospital policies, procedures, and HIPAA compliance requirements.
- Collaborated with the Enrollment team to ensure changes are made when provider enrollment errors occur.
- Collaborated with cross-functional teams for timely resolution of enrollment issues, improving overall customer satisfaction.
- Streamlined provider enrollment processes by implementing efficient data management systems.
CATASTROPHE CLAIMS ADJUSTER
PROPERTY CLAIM SPECIALIST ALACRITY SOLUTIONS DALLAS TX.
08.2020 - 11.2020
- Handled 50+ calls daily
- Determined total loss and claim value and considered depreciation when moving a claim to closure
- Had knowledge of coverages provided within various homeowner policies
- Determined claim value, considered depreciation and actual cash value
- Responsible for Quality first contact, obtained information and maintained accurate records about incidents/loss from insured through calls and written reports
- Determined coverage approval/denial
- Notified insured of relevant policy information
- Explained coverage of loss, assisted policy holder of itemization of damages, emergency repairs and additional living arrangements
- Investigated claim damages using internal and external resources
- Spoke with the insured and involved parties like contractors.
Customer Service Representative
Vixxo Real Estate holdings. Atlanta, GA
04.2017 - 07.2020
- Handled 50+ calls daily
- Received inbound calls from clients for real estate business or complaints and made outbound calls to service providers for issue resolution
- Reassigned work orders to appropriate personnel
- Placed outbound calls to clients to inquire about problems encountered and sent out appropriate technicians for service provision
- Opened and maintained clients’ accounts by recording account information
- Resolved product or service problems by clarifying the customer's complaint; determined the cause of the problem; selected and explained the best solution to solve the problem; expedited correction or adjustment; followed up to ensure resolution
- Prepared product or service reports by collecting and analyzing client information
- Contributed to team effort by accomplishing related results as needed
- Kept records of clients’ interactions, processed clients’ accounts and filed documents
- Followed communication procedures, guidelines, and policies.
Education
Bachelor of Science - Mass Communication
Madonna University
Nigeria8 2014
Skills
- Customer relationship
- Effective communication
- Attention to detail
- Medical billing
- EMR software proficiency
- Management collaboration
- Salesforce
- Proficient in Excel
- HIPAA Compliance
- Provider enrollment
- Strategic Thinking
- Epic
- Training and coaching
- Healthcare Industry Knowledge
- Medicare and Medicaid knowledge
Timeline
Provider Enrollment Analyst
Palmetto Gba - Broadpath Llc
03.2025 - 03.2026
Provider Enrollment Analyst
CGS Administrative - Broadpath Llc
01.2024 - 02.2025
Revenue Cycle Specialist
Accenture Health
01.2022 - 12.2023
Data Entry/Provider Enrollment Specialist
Star Pediatric (Remote)
12.2020 - 12.2021
CATASTROPHE CLAIMS ADJUSTER
PROPERTY CLAIM SPECIALIST ALACRITY SOLUTIONS DALLAS TX.
08.2020 - 11.2020
Customer Service Representative
Vixxo Real Estate holdings. Atlanta, GA
04.2017 - 07.2020
Bachelor of Science - Mass Communication
Madonna University