Michael Adebowale
Credentialing Specialist
Lagos,Nigeria
Summary
Experienced Health Credentialing Specialist with a strong background in remote work environments. Skilled in managing all aspects of credentialing processesespecially for mental health practitioners, including primary source verification and application management. Proficient in navigating complex credentialing requirements and maintaining accurate provider data while working remotely. Effective communicator with a proven ability to collaborate with internal teams. Committed to upholding integrity and confidentiality in credentialing activities. Ready to leverage remote work expertise to drive excellence in health credentialing and contribute to the advancement of healthcare delivery.
Overview
6
6
years of professional experience
4
4
years of post-secondary education
4
4
Certifications
Work History
Credentialing Specialist
Wellnite Inc.
01.2023 - Current
- Verified provider credentials through primary source verification, leveraging resources such as the National Practitioner Data Bank (NPDB) and Federation of State Medical Boards (FSMB) to confirm education, training, licensure, and work history.
- Successfully managed provider enrollment with the Council for Affordable Quality Healthcare (CAQH), ensuring accurate and timely completion of applications and updates to provider profiles.
- Reviewed and processed credentialing applications for participation in insurance networks, Medicare, and Medicaid, adhering to payer-specific requirements and deadlines to ensure seamless enrollment.
- Conducted proactive outreach to providers to obtain missing documentation, clarify discrepancies, and facilitate the completion of credentialing applications, ensuring a smooth and efficient process.
- Maintained meticulous and up-to-date provider files in credentialing software systems, including Cactus, MD-Staff, and IntelliCred, to ensure data integrity and accuracy.
- Collaborated with cross-functional teams and external stakeholders to optimize credentialing processes, enhance efficiency, and promote compliance with accreditation standards and regulatory requirements.
- Conducted regular audits of provider data to identify and address inaccuracies, ensuring continued compliance and mitigating potential risks.
Retail Processing and Customer Service
Allianz Nigeria Insurance Plc
1 2019 - 12.2020
- Prepare weekly and monthly Enterprise Risk Management report
- Handle Client’s enquiry, complaint and request in accordance with the company’s guidelines and policies
- Advise Client on duly best actions on policy
- Sales of Company’s products and services
- Answering telephone calls and making the appropriate transfers
- Processing new client accounts, maintaining customer accounts, implementing changes to existing accounts, and filing documents and other paperwork
- Reconciliation of Client’s policy statement with bank’s statement of account.
Admin Assistant
Mastared Nigeria Limited
01.2018 - 12.2018
- Management of office equipment
- Maintaining a clean and enjoyable working environment
- Handling external or internal communication or management systems
- Organizing, arranging and coordinating meetings
- Fleet management and maintenance
- Supervision and allocation of duties to subordinates
- Statutory Government taxes and levy administration
- Purchase and ensure office supplies are well stocked
- Ensures issues related to maintenance are promptly reported and resolved
- Carry out any other tasks as assigned from time to time.
Accountant
Mastared Nigeria Limited
1 2016 - 12.2016
- Prepared account books and issued receipt, prepared monthly payroll of workers
- Daily cash deposit in commercial bank in line with administrative requirements
- Fleet management and maintenance
Education
MSc - Economics -
01.2017 - 04.2018
B.Sc - Economics (2.1) - undefined
03.2011 - 05.2014
Skills
Microsoft Office suite
Analytical and Critical Thinking
Remote Conferencing and Communication
CAQH, PECOS, NPPES, and CMS databases expertise
Data Management
Written and Oral Communication
Organizational Skills
Problem-solving abilities
Customer Relationship Management
Attention to Detail
Multitasking
Certification
Skills for Inclusive Conversations, 09/01/19
Hobbies
Computer Hardware Troubleshooting, Swimming and Travelling
References
- Available upon request
Timeline
Credentialing Specialist - Wellnite Inc.
01.2023 - Current
Admin Assistant - Mastared Nigeria Limited
01.2018 - 12.2018
University of Lagos - MSc - Economics,
01.2017 - 04.2018
Landmark University, Omu-Aran - B.Sc - Economics (2.1),
03.2011 - 05.2014
Retail Processing and Customer Service - Allianz Nigeria Insurance Plc
1 2019 - 12.2020
Accountant - Mastared Nigeria Limited
1 2016 - 12.2016