Jasmine P. Email & Phone Number

• Administer and manage credentialing and re-credentialing for health plans, pharmacy benefit managers (PBMs), and all pharmacy sites, ensuring compliance with regulatory, accreditation, and managed care plan standards.• Troubleshoot and resolve payor-related departmental issues, maintaining confidentiality of sensitive pharmacy and provider information.• Track pharmacy license expirations, advising pharmacy sites and pharmacists on renewal processes while submitting all renewals• Process Medicaid applications, renewals, and revalidations, maintaining portal access and managing billing-related tasks.• Oversee NPI profile updates, Medicare (PECOS) processing, NCPDP, and pharmacy Continuing Education Units for RFPs.• Support accreditation renewals (URAC, ACHC, NABP) and submit Fraud, Waste, and Abuse attestations to health plans annually.• Manage and maintain both electronic and physical credentialing files for all pharmacy sites, ensuring data accuracy and regulatory compliance.• Suggest and implement improvements to credentialing policies and procedures as needed.

• Coordinated appointments between insurance adjusters and claimants, managing digital calendars and resolving conflicts.• Communicated with mortgage companies, contractors, and insurance carriers to track payment status and claims processing.• Prioritized high-urgency appointments and addressed scheduling challenges efficiently.• Ensured compliance with company policies and delivered exceptional customer service.• Worked primarily within the system of Nimbus.

• Ensured all licenses for healthcare providers and facilities were current and renewed on time.• Initiated and completed license renewals two months prior to their expiration dates to prevent lapses.• Managed Medicare PTAN revalidations to maintain compliance with federal regulations.• Handled Medicaid applications and revalidations to ensure uninterrupted service provision.• Oversaw NCPDP recredentialing processes to maintain pharmacy compliance and standards.• Directed all aspects of pharmacy-related credentialing and application processes.• Maintained an accurate and up-to-date rent roll for commercial rental properties.• Drafted lease agreements and facilitated electronic signatures to streamline property managementoperations.• Requested and managed insurance contracts to ensure proper coverage and compliance.• Added, removed, and updated NPI’s on NPPES website• Utilized PECOS system• Added, updated, and revalidated Express-Scripts

Orlando, Florida, United States

• Managed team responsibilities, ensuring efficient workflow and task completion.• Hired, trained, and mentored employees, fostering a productive and collaborative work environment.• Oversaw all outgoing communications, maintaining professional and timely correspondence.• Processed payments accurately and efficiently, ensuring financial records were up-to-date.• Handled daily order processing, confirming orders, and initiating billing procedures.• Coordinated with Medicare, Medicaid, and commercial insurances, ensuring compliance and properbilling.• Requested prior authorizations from insurance companies for medical items and services.• Adhered to insurance guidelines to ensure coverage for medical items and services.• Promoted to Office Manager within six months of initial employment, reflecting strong performanceand leadership skills.

Fort Lauderdale, Florida, United States

Inputted daily durable medical equipment orders while delivering exceptional customer service. Health with Medicare, Medicaid, and various commercial insurances such as Blue Cross and Blue Shield, Cigna, Aetna, etc, and Wellcare.

Delray Beach, Florida, United States

• Answered approximately 60 or more calls a day from patient's of the Greater Lawrence Family Health Center. • Recruited and trained team members• Conducted weekly meetings to review team and individual goals• Scheduled patient appointments• Communicated with nurses and doctors, relaying phone notes and flags• Sent pages and handled insurance verification• Assisted patients over the phone with results and referrals• Managed completion and information dissemination of referrals

Bachelor Of Arts - Ba, Crisis/Emergency/Disaster Management

Concentration on pre-medicine

High School Diploma