Sumur Stephens

• Preforming audits on credentialing associate files within a timely and accurate manner to ensure they are in compliance with NCQA and state specific regulations.

Credential providers and facilities within a timely and efficient manner for the state of Louisiana, ensure the documentation is correct and current with Humana and Louisiana state regulations. Work within multiple systems such as Apex, PAAG, PMDM, PowerBi and multiple education and process documents.

• Developed and maintained detailed customer databases to enhance team efficiency.
• Ensured compliance with applicable laws and regulations related to selling activities.
• Handled high volume work loads to meet deadlines for processing applications for customers applying for Insurance.

• Developed case studies, role-plays, videos, and other interactive activities to enhance learning experience.
• Assisted with the implementation of new processes and procedures related to quality assurance.
• Conducted regular assessments to measure employee understanding of quality processes.
• Kept records of quality reports and statistical reviews.