Analytical and knowledgeable Provider Enrolment Specialist with extensive knowledge of credentialling and enrolment.Has extensive experience in the healthcare industry. Possesses a Bachelor’s Degree in Business Administration and more than nine years of Provider Enrolment Specialist experience.
Good written and oral communication skills
Extensive knowledge of conducting eligibility interviews
Strong analytical skills
Understanding of insurance regulations and enrolments
Able to answer questions regarding insurance products
Strong knowledge of credentialling process for providers
Above-average computer skills and knowledge of applicable computer applications
September 2009 to July 2014 Health Systems, Inc.Â—London, UK Provider Enrolment Specialist
Oversaw processing of and preparation of new member enrolments.
Completed dis-enrolments as needed.
Verified and corrected member eligibility issues at least monthly.
Communicated with members and doctors regarding benefits.
Utilised state enrolment systems and managed care enrolment systems.
Conducted all work in accordance with the confidentiality requirements mandated by HIPAA for member information.
Completed newborn enrolments and notified state of deceased member dis-enrolments.
May 2005 to August 2009 United Healthcare, Inc.Â—London, UK Provider Enrolment Specialist
Verified eligibility for all departments and completed updates of Managed Care System.
Reported enrolment trends and all problems to management at weekly meetings.
Completed credentialling applications for providers.
Monitored all enrolments to identify any processing problems.
Completed other duties as assigned.
2005 London Pacific University, London, England Bachelor’s in Business Administration
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