Summary
Overview
Work History
Education
Skills
References
COMMUNICATION
Timeline
Generic
Madeline Jacks

Madeline Jacks

Oklahoma City

Summary

Experienced in credentialing procedures and maintaining compliance standards. Utilize data analysis and documentation skills for accurate and timely credentialing processes. Possess knowledge of regulatory requirements and best practices, allowing for efficient navigation of complex industry guidelines. Adept at identifying and resolving discrepancies to ensure seamless coordination between healthcare providers and insurance companies. Dedicated to upholding the highest standards of quality and accuracy in all credentialing activities.

Overview

9
9
years of professional experience

Work History

Credentialing Analyst

Media Riders
02.2024 - 11.2024
  • Ensured accuracy in data entry by carefully reviewing applicant information before inputting it into the system.
  • Assisted in maintaining an updated database of credentialed providers, allowing for quick access to essential information when needed by senior management or other departments within the organization.
  • Extensive knowledge with running and analyzing dental credentials such as DEA licenses, NPDB reports, Dental licenses, OIG reports, NBDE reports, educational requirements, state specific requirements, Anesthesia licenses, ADA reports.
  • Expedited the onboarding process for new providers by accurately verifying their education, training, experience, certifications, and licenses within strict timelines.
  • Enhanced department productivity with proper organization and timely completion of tasks.
  • Troubleshot issues with electronic applications, quickly identifying problems and implementing solutions to maintain workflow efficiency.
  • Contributed to a positive working environment by collaborating with team members and sharing expertise on credentialing processes.
  • Completed comprehensive background checks, ensuring all candidates met company standards for quality care provision.
  • Successfully resolved complex issues regarding licensing discrepancies or other concerns involving provider qualifications.
  • Enrolled providers and Medicaid, Medicare, and private insurance plans.
  • Received and evaluated applications to look for missing and inaccurate information.
  • Maintained up-to-date knowledge of applicable laws and regulations.
  • Created and maintained compliant work environment.
  • Identified gaps in existing compliance processes and recommended updates.
  • Conducted periodic compliance audits and reviews to identify areas of improvement.
  • Developed and implemented corrective action plans for non-compliance issues.
  • Kept informed regarding pending industry changes, trends or best practices.
  • Investigated locations to confirm license data, conducted background checked and assessed premises for compliance with licensing requirements.
  • Completed field checks to verify licenses and permits for various business.
  • Confirmed data and licensing information through investigations and notified violators of required changes to bring operations into compliance.
  • Obtained NPI numbers for providers and facilities and updated existing profiles.
  • Developed user-friendly guides for healthcare professionals seeking credentialing assistance, streamlining their experience while ensuring compliance with internal protocols and external regulations.

Quality Assurance Analyst

Media Riders
08.2023 - 11.2024
  • Mentored and coached team members on QA topics and strategies.
  • Participated in regular meetings with cross-functional teams to discuss progress updates, communicate concerns or challenges, and ensure alignment of project goals.
  • Reported progress, test metrics and results to project stakeholders.
  • Maintained comprehensive knowledge of relevant industry regulations and standards, ensuring compliance throughout the QA process.
  • Streamlined QA processes for increased efficiency and reduced time spent on redundant tasks.
  • Championed quality assurance initiatives within the organization by promoting a culture of continuous improvement and striving for excellence in all aspects of product development.
  • Processed team trackers with accurate scoring, and monthly averages for each team member assigned.
  • Created materials to better assist team members in areas that required improvement.

Member Service Representative

Media Riders
04.2023 - 11.2024
  • Accepting incoming calls generated by the CXOne system. Providing exceptional service to members that call in for assistance for a wide range of reasons. Correctly notating the member’s account. Correctly dispositioning the nature of the call in the CXone system and in dentatrac software. Assisting members with the necessary resources and information.
  • Informed members of policies and procedures.
  • Maintained accurate records of member communications, transactions, policies, and other relevant documentation for seamless operations within the agency.
  • De-escalated and resolved customer complaints with punctual, polite and professional service.
  • Delivered exceptional customer service by proactively addressing concerns and fostering a positive experience throughout all interactions.
  • Enhanced client satisfaction by promptly addressing inquiries and providing accurate information on products and services.
  • Consistently met compliance requirements for the agency by promptly completing mandatory continuing education courses and staying current on industry regulations.
  • Tailored communication strategies to different client segments, improving engagement.

Bud Tender

The Green Temple
04.2019 - 10.2020
  • Checking in patients, assisting patients with product knowledge, assisting patients in obtaining the correct products for their individual needs, general housekeeping, wiping glass showcases, product inventory, product packaging and labeling, opening and closing the store.

Property Manager

Trinity Multi Family
05.2017 - 02.2019
  • Managing apartment complex, showing units, leasing units, preparation and signing of lease contracts, filing, opening and closing the office, managing staff, assisting tenants, general housekeeping, entering work orders, updating marketing tools, hosting tenant gatherings, maintaining a clean and calm environment.

Call Center Representative

Cole Hardgrass Call Center
05.2016 - 04.2017
  • Generated calls, performed surveys, data entry, script reading, and customer service, and completed survey questions on behalf of clients on the phone.

Education

High School Diploma -

Calera High School
Calera, Oklahoma

Skills

  • Effective communication
  • Strategic leadership
  • Thorough in quality assurance
  • Detail-oriented organization
  • Innovative thinking
  • Analytical thinker
  • Credential verification
  • Compliance
  • HIPAA compliance
  • Healthcare regulations
  • Ethical standards
  • Insurance procedures
  • Provider enrollment
  • Document review
  • Data management
  • Credentialing oversight

References

Available upon request.

COMMUNICATION

I humbly pride myself on having great communication with my superiors and with the members that I assist daily. I have received two completed surveys based on my performance with the members that were acknowledged by my team leads and supervisor. I have received recognition from my superiors, QA instructors, and HR for my hard work and eagerness to learn and grow.

Timeline

Credentialing Analyst

Media Riders
02.2024 - 11.2024

Quality Assurance Analyst

Media Riders
08.2023 - 11.2024

Member Service Representative

Media Riders
04.2023 - 11.2024

Bud Tender

The Green Temple
04.2019 - 10.2020

Property Manager

Trinity Multi Family
05.2017 - 02.2019

Call Center Representative

Cole Hardgrass Call Center
05.2016 - 04.2017

High School Diploma -

Calera High School

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