LP
Open to opportunities

Lew Pezuzu

@lewpezuzu

Detail-oriented credentialing specialist with expertise in healthcare operations.

United States

What I'm looking for

I am looking for a role that offers growth opportunities in healthcare operations, where I can leverage my credentialing expertise and technical skills.

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

EH

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.

OM

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

AS

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

NA

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 logoFU

Franklin University

Bachelor of Science, Cybersecurity

0

Currently pursuing a Bachelor of Science in Cybersecurity. This degree is aimed at expanding technical acumen in healthcare operations.

PD

P.S.S. Douala

High School Diploma, Sciences

0

Tech stack

Software and tools used professionally

Find your dream job

Sign up now and join over 85,000 remote workers who receive personalized job alerts, curated job matches, and more for free!

Sign up
Himalayas profile for an example user named Frankie Sullivan
Lew Pezuzu - IT Helpdesk Support Specialist - Elevance Health | Himalayas