CHANDRA CAREY
Alexander
Summary
Experienced credentialing professional with a successful history of overseeing and managing credentialing operations to ensure compliance. Recognized for exceptional collaborative skills and a track record of achieving results through efficient processes. Highly regarded for adaptability and reliability in dynamic environments, with expertise in documentation and regulatory standards.
Overview
18
18
years of professional experience
Work History
Provider Credentialing Specialist
Arkansas Blue Cross and Blue Shield
06.2021 - Current
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Conducted audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
Benefits Verification Representative
Arkansas BlueCross & BlueShield
02.2014 - 06.2021
- Efficiently perform insurance verification, pre-authorization and pre-certification functions
- Answer insurance benefit related questions and provide claim status to healthcare providers and members
- Respond to queries, solve and refer problems while following up with providers and members to increase satisfaction
- Stay current on HIPAA regulations, benefits, claims processing, medical terminology and other procedures
- Exceeded client expectations by consistently delivering high-quality verification results in a timely manner, contributing to the company''s strong reputation for excellence.
- Work with utilization review department to ensure proper documents are received in order to make a clinical determination
- Input data into system maintaining accuracy of provider coding information and reported services
- Verified insurance benefits and obtained pre-authorizations before any medical procedures were performed.
- Continuously monitored progress towards project goals while reevaluating timelines and adjusting strategies as needed to ensure successful outcomes.
Loss & Mitigation Specialist
Ally Financial
08.2006 - 04.2011
- Utilized dynamic negotiation skills and business acumen to successfully manage a multi-million dollar portfolio annually
- Interfaced with internal departments to expedite collection efforts and work collaboratively regarding workflow process
- Recognized for aggressively pursuing accounts through relationship-focused account management resulting in achieving record breaking sales and earning several Employee of the Month Awards and two consecutive Professionalism Awards
Education
Master of Business Administration -
UNIVERSITY OF PHOENIX
12.2015
Bachelor of Science - Sports Management
UNIVERSITY OF TENNESSEE MARTIN
Martin, TN12.2005
Skills
- Accuracy and precision
- Background checks
- Records maintenance
- Benefits verification
- Customer service
- Attention to detail
- HIPAA compliance
- Communication and interpersonal skills
- Provider enrollment
- Data management
Timeline
Provider Credentialing Specialist
Arkansas Blue Cross and Blue Shield
06.2021 - Current
Benefits Verification Representative
Arkansas BlueCross & BlueShield
02.2014 - 06.2021
Loss & Mitigation Specialist
Ally Financial
08.2006 - 04.2011
Master of Business Administration -
UNIVERSITY OF PHOENIX
Bachelor of Science - Sports Management
UNIVERSITY OF TENNESSEE MARTIN
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