Lew Pezuzu
@lewpezuzu
Detail-oriented credentialing specialist with expertise in healthcare operations.
What I'm looking for
I am a credentialing specialist with over 4 years of experience in provider enrollment, recredentialing, and payer communication across various health plans. My expertise lies in managing credentialing workflows using platforms such as CAQH, PECOS, and Salesforce Health Cloud, ensuring compliance with HIPAA and regulatory guidelines. I pride myself on my ability to collaborate effectively with providers, office staff, and insurers to resolve credentialing issues and expedite application timelines.
Currently pursuing a Bachelor's Degree in Cybersecurity, I am committed to expanding my technical acumen in healthcare operations. My bilingual proficiency in English and French enhances my communication skills, allowing me to connect with a diverse range of stakeholders. I have a proven track record of streamlining credentialing processes, improving accuracy, and ensuring timely submissions, which has been instrumental in maintaining compliance and enhancing operational efficiency.
Experience
Work history, roles, and key accomplishments
IT Helpdesk Support Specialist
Elevance Health
Dec 2024 - Mar 2025 (3 months)
Provided comprehensive remote IT support to over 200 users, addressing hardware, software, and network issues critical to healthcare operations. Managed technical issues related to provider enrollment systems, electronic health records (EHR), and secure access to healthcare applications, ensuring smooth integration and troubleshooting access problems with platforms like Salesforce Health Cloud.
Credentialing Specialist
Ohio Department of Medicaid
Jul 2022 - Nov 2024 (2 years 4 months)
Managed the complete lifecycle of provider enrollment, credentialing, and recredentialing for Medicaid and Managed Care plans, ensuring accuracy and compliance with state and federal regulations. Utilized various credentialing platforms including Optum, Availity, PECOS, and CAQH to submit and track applications and manage provider status. Acted as a liaison between providers, insurance carriers, a
Customer Service Representative
Automated Health Systems
Sep 2021 - Jun 2022 (9 months)
Delivered exceptional service to clients in the health insurance sector, guiding them through benefits, eligibility, claims, and coverage issues. Handled a high volume of inbound calls, resolving inquiries efficiently while adhering to HIPAA and regulatory standards. Used CRM systems to document customer interactions, track issues, and ensure follow-up on unresolved matters, resulting in increased
Solutions Specialist
Nationwide
Dec 2020 - Mar 2021 (3 months)
Provided expert consultation to clients in retirement planning, life insurance, and loan products, ensuring they understood their options and selected the best solutions for their financial goals. Assisted customers in navigating insurance and retirement plan documents, explaining policy details, riders, and potential payouts clearly and effectively. Used CRM systems to track customer interactions
Education
Degrees, certifications, and relevant coursework
Franklin University
Bachelor of Science, Cybersecurity
Currently pursuing a Bachelor of Science in Cybersecurity. This degree is aimed at expanding technical acumen in healthcare operations.
P.S.S. Douala
High School Diploma, Sciences
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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