OLUWADAMILOLA EMMAUNELLA EZEADUM
Richmond,TX
Summary
Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills. Achievements include completing more than 100 healthcare provider applications each month with no critical errors. Highly organized and detail-oriented with in-depth knowledge of insurance regulations. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
6
6
years of professional experience
Work History
Credentialing Specialist (Intake/Initial)
Elevance Health
01.2019 - Current
- Processing paperwork relating to re-credentialing and ensuring databases detailing practitioners' education, training, licensing, experience and other information are up to date
- Coordinating, processing and completing credentialing functions of all Providers in accordance with NCQA, State and Federal requirements
- Participate in development of internal credentialing processes
- Monitoring progress and completion of all sites visit by Provider Network Team to ensure completion within established timeframe
- Assisting credentialing supervisor in preparation of NCQA, IMQ and other related health plans audits of provider credentialing files
- Identifying issues that require additional investigation and evaluations
- Validates discrepancies and ensures appropriate follow up by contacting practitioners to clarify discrepancies
- Aids in gathering data for on boarding provider and Maintenance of CAQH on schedule
- Conducted primary source verifications such as background checks and board certifications.
- Received and evaluated applications to look for missing and inaccurate information.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Prepared records for site visits and file audits.
- Gained extensive knowledge in data entry, analysis and reporting.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
Customer Care Representative
Love Hands Executive Care
01.2018 - 12.2018
- Resolving issues between clients and employees.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Responded to customer needs through competent customer service and prompt problem-solving.
- Assisted call-in customers with questions and orders.
- Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
- Built long-term, loyal customer relations by providing top-notch service and detailed order, account and service information.
- Maintained accurate and current customer account data with manual forms processing and digital information updates.
- Resolved concerns with products or services to help with retention and drive sales.
- Logged call information and solutions provided into internal database.
- Educated clients on account services and resolved client inquiries regarding statement information and account balances.
- Coordinated timely responses to online customer communication and researched complex issues.
- Created customer profiles by answering questions and providing tailored experiences based on interests and agendas.
- Described product highlights and benefits to help guide purchasing decisions.
Customer Care Representative
Access Bank
10.2015 - 01.2017
- Receiving and attending to customers’ complaint on phone
- Ensure that needs and wants of customers’ are met
- Monitoring Real-time card transactions of high profile customers of bank
- Ensuring that customers are well-informed of products and services of bank
- Solving customer’s issues and attending to their needs through effective time management
- Empathy for customer’s issues thereby finding solutions to their concerns.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Responded to customer needs through competent customer service and prompt problem-solving.
- Assisted call-in customers with questions and orders.
- Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
- Built long-term, loyal customer relations by providing top-notch service and detailed order, account and service information.
- Maintained accurate and current customer account data with manual forms processing and digital information updates.
- Educated clients on account services and resolved client inquiries regarding statement information and account balances.
- Resolved concerns with products or services to help with retention and drive sales.
- Logged call information and solutions provided into internal database.
- Coordinated timely responses to online customer communication and researched complex issues.
- Created customer profiles by answering questions and providing tailored experiences based on interests and agendas.
- Described product highlights and benefits to help guide purchasing decisions.
- Maintained superior quality by reducing downtime to maximize customer support and meet revenue goals.
- Leveraged sales expertise to promote products and capitalized on upsell opportunities.
- Achieved long-term business objectives by analyzing customer feedback for process improvements.
- Increased client retention by managing supplier deliveries around client needs.
- Eliminated inefficiencies by educating and training new employees on best practices and customer care procedures.
Front Desk Personnel
Travel House Budget Hotel
Lagos
07.2015 - 09.2015
- Welcoming of clients into the hotel
- Sensitize customers on company’s services
- Check in customers
- Ensure proper receipts and record of payments from customers
- Attend to customers’ needs and complaints
- Ensure proper reports of day’s activities
- Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
- Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.
- Resolved customer issues quickly and notified supervisor immediately when problems escalated.
- Maintained files and records by implementing effective filing systems that boosted efficiency and organization.
- Transcribed phone messages and relayed to appropriate personnel.
- Used internal software to process reservations, check-ins and check-outs.
- Collected room deposits, fees and payments.
- Monitored office supplies by checking inventory and placing orders.
- Used quick response and dynamic service skills to build relationships with patrons, improving customer retention rate.
- Kept accounts in balance and ran daily reports to verify totals.
- Confirmed relevant guest information and payment methods to prevent fraud.
- Retrieved mail, packages and documents on behalf of guests, promptly verifying receipt and arranging for pickup or transmittal.
- Calculated billings and posted charges to room accounts, reviewing charges with guests at checkout.
- Entered customer data into room system and updated information whenever patrons changed rooms.
- Maintained transaction security by verifying payment cards against identification.
- Reported facility and room maintenance problems to appropriate personnel for immediate remediation.
- Contacted housekeeping staff and maintenance department immediately to resolve guest room issues.
- Responded swiftly to room requests and other inquiries made via establishment website, email or phone.
- Updated customer accounts with add-on room charges, minibar use and room service bills.
- Prepared weekly employee work schedules for team members.
- Protected guest valuables with main safe or in individual boxes to maximize security.
- Planned coverage needs and organized services to support incoming special events.
Education
Bachelor of Science - Mass Communication
Covenant University
Nigeria07.2012
Skills
- Proficiency in Microsoft Office, CRM applications, Bank solutions application
- Excellent written communication skills
- Client relationship management
- Effective in Microsoft teams
- Excellent listening skills
- Ability to solve problems through bank solutions and CRM
- Good team player and goal getter
- Conflict resolution skills
- Use of Cactus for documentation of provider’s information
- Effective use of BPM to upload documents for provider’s verification
- Provider Enrollment
- Employment Data Tracking
- Applicant Qualification
- Credential Verification
- Confidential Records Management
- Credentialing Requirements
- Americans with Disabilities Act (ADA)
- Credentialing Policies
- Analytical and Critical Thinking
Accomplishments
- EC-COUNCIL CUSTOMER RELATIONSHIP MANAGEMENT COMPTIA PROJECT +(JUNE, 2012)
- MACNEL CONSULT COURSE IN WORK ETHICS, CUSTOMER SATISFICATION
- (FEBRUARY, 2014)
Timeline
Credentialing Specialist (Intake/Initial)
Elevance Health
01.2019 - Current
Customer Care Representative
Love Hands Executive Care
01.2018 - 12.2018
Customer Care Representative
Access Bank
10.2015 - 01.2017
Front Desk Personnel
Travel House Budget Hotel
07.2015 - 09.2015
Bachelor of Science - Mass Communication
Covenant University
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