Credentialing Coordinator which involves: helping providers with their licenses, board certificates, malpractice coverage, hospital appointments, etc.
- Credentialing Coordinator at South Shore Medical Center
- Hosp. registrar & support at Shriners Burns Hospital
14 years, 9 months at this Job
- - Business Management
This position was to assistant the Credentialing Coordinator in all Credentialing for all providers, maintain licenses, work with\ Insurance carriers maintaining active enrollment for GI Associates.
- Credentialing Assistant/Credentialing Coordinator at Gastrointestinal Associates, PA
- Executive Assistant / Credentialing Specialist at Baptist Medical Center
- Executive Assistant at
- Office Manager at BIPEC
10 months at this Job
- High School Diploma
As a Credentialing Coordinator I'm responsible for completing a files for clients in a timely manner. My duties are to pull different state licenses and other related documents for that client. I also find and verify hospital verifications for that clients file using Adobe PDF. Other duties consist of sanction monitoring; where I search each type of doctors degree and different boards for all 50 states and dock those with a record. Sanction Monitoring is usually a two week process.
- Credentialing Coordinator at GEMINI DIVERSIFIED SERVICES
- Costumer Service Representative at Enterprise Car Rental Service
- Criminal Research Specialist at Accurate Background, Inc.
- Shipping/Receiving Clerk, Food Prep at Disneyland
4 months at this Job
- AA - Business/ Marketing
Health Network formerly known as: Vermont Managed Care, Colchester, VT. January 2011-present Credentialing Coordinator 1 Credentialing of physicians and midlevel providers for initial appointment and re-appointment to the Vermont Managed Care network. 2 Verification and primary source of completed application, Licensure, Board Certification, DEA, Education, work history, references, hospital privileges, malpractice history and insurance, Medicare and Medicare sanctions checks, and National Practitioner Data bank checks. 3 Preparation of the monthly agenda to be sent out to the Credentials Committee members, previous meeting minutes. 4 Responsible for running the Credentials Committee meetings in turn and bringing all derogatory information for providers before the committee for discussion and approval. 5 Monthly Medicare and Medicaid sanctions checks. 5 Preparation of grid report of providers approved for appointment/re-appointment to be emailed to payers. 7 Knowledge of NCQA and Rule 10 Guidelines. 7 CAQH research and maintenance of Roster and downloading of completed applications. 7 Attendance of yearly conferences for NAMSS, Vistar. 7 Audited Credentialing files delegated to Copley, Porter, and Northwestern Hospitals. 7 Collection and proofing of NPI numbers from providers. 7 Received recognition award for work on NPI numbers. 7 Daily interaction with physicians in the community and Fletcher Allen Health Care in addition to the Medical Staff Office at Fletcher Allen Health 14. Integrating and Credentialing new Hospitals that have joined the UVMMCHN Such as Central Vermont Medical Center, Champlain Valley Physicians Hospital, Porter Medical Center, Alice Hyde, Elizabethtown Hospital.
- Credentialing Coordinator at UVM Medical Center
- Billing Team Coordinator at HowardCenter
- Credentialing Coordinator at Credentials Committee
- Medical Claims Processor at Employers Mutual Inc
8 years, 2 months at this Job
- Enroll providers in governmental payers using PECOS and CORE MMIS - Maintain providers CAQH and NPI accounts - Ensure provider has an Indiana State License, CSR, Board certification and DEA - Enroll Residents for Community Group Family Medicine and Psychiatry - Revalidate locations and providers in Medicare and Medicaid - Use Excel, Word, and Adobe PRO daily - Created new training manual for Credentialing Coordinator position and new Excel spreadsheets for fellow coworkers to utilize
- Credentialing Coordinator at Community Health Network
- Patient Service Representative at Community Hospital South
- Office Coordinator Assistant at Sweetbay Supermarkets
- Customer Service Clerk at Sweetbay Supermarkets
1 year, 11 months at this Job
- High school or equivalent
• Interim staff credentialing coordinator assignments nationwide
• Interim provider enrollment assignments nationwide
• Conduct primary source verification and credentialing and privileging for initial and reappointments
• Ensure files are in compliance with various accreditation/regulatory and/or state agencies
- Interim Credentialing Specialist/Credentialing Coordinator at Hardenberg Group
- Credentialing Specialist at North Shore Medical Center
- Credentials Coordinator at Boston Medical Center
- Provider Enrollment Coordinator at Tufts Medical Center
6 months at this Job
- Bachelor of Science
- Associates of Arts in Education - Education
Started as a temp in Accounts Payable helping with vouching over 200+ invoices into Great Plains. During my temping contract I was moved to Payroll and helping with time sheets and preparing checks for over 300+ employees. Became permanent in March as an Accounting Assistant helping with Account Receivables and Cash Disbursements. I reconcile the bank accounts using Great Plains, prepare monthly reports for Capitation members and prepare invoices. Transferred departments in Aug. 2016 to the Business Office and started a new role as a Business Service Coordinator, I am working on patient accounts using IDX and refunding any accounts with a credit balance to either patients that overpaid or insurances that overpaid. Transferred to a new department Aug. 2017, working as a Credentialing Coordinator. Focusing on initial credentials and re-credentials, monthly background checks on physicians, setting up hospital privileges and adding physicians to health plans.
- Credentialing Coordinator at Verity Medical Foundation
- Retail Sales Associate at CENTERPLATE AT LEVI'S STADIUM
- APPAREL GRAVEYARD LEAD at AEROTEK (ZAZZLE)
- ASSISTANT STORE MANAGER at YESSTYLE FASHION
4 years, 4 months at this Job
- Associate - Business Administrative
- - HiSet equivalent certificate
Supports credentialing responsibilities required throughout the credentialing and privileging process of Healthcare Providers . By partnering with internal Credentialing Analysts and our front office teams. The Credentialing Coordinator is responsible for important administrative functions of the credentialing process, in order to achieve compliance for on-time start dates.
• Complete online applications on behalf of providers’ and assist in reviewing requirements including licensure, certifications, screens and other critical documents using the internal systems such as SharePoint and Salesforce .
• Communicate professionally in a timely manner using various communication such as email, phone, or internal communication such as notes to facilitate a team approach to gathering all required documents, for example education verification, obtaining phone and fax numbers for past work history, requesting case logs, etc.
• Run reports for both workforce planning and pending starts meetings for various specialties throughout the department.
• Facilitate internal tracking system (SharePoint) to assist in the maintenance of data, building internal benchmarking for team members and assisting in supporting the team member to ensure the data reflects real-time status.
• Collaborate with Credentialing Analysts to review all incoming new client requests or contract revisions for Credentialing requirements, for assigned facilities in order to identify unique requirements.
• Provide administrative support to the Credentialing Analysts teams by completing check requests, scheduling drug screens, completing followup calls, creating FedEx labels, etc
• Taking on reappointment's to help re credential providers In a timely matter so their privileges wont be discontinued.
• Prime Sourcing verification for Work/Affiliation history,Peer reference,education, Claims History for specific clients in a timely matter and communicating with MSO, Credentialing Departments,Human Resources, and Risk Management Departments.
- Credentialing Coordinator at AMN Healthcare
- Material Management at Dallas medical city
- Materials Management at Dallas Medical Center
- Testing Technician at Gdt manufacturing
1 year, 2 months at this Job
Compliance and credentialing coordinator, Sleepmed Inc July 2002 to present My current position is an amalgamation of four key work tracks, outlined below, and an evolution of all the duties, responsibilities and accomplishments that I have performed since joining SleepMed, Inc. Implementation Specialist · Coordinated efforts successfully for a cross functional team in the project planning, implementation and control phases of a substantial Software Development project that integrated numerous legacy software systems into the creation of a company-wide proprietary software program. Aided as Chief Tester of software before updates and release. Managed the edits during onsite evaluation process phase. · Implementation Lead for Paperless Environment initiative and Go Live Support for its new best practices. Software Trainer · Trained staff and new hires in new software functionality to optimize use and customer retention post purchase. Wrote protocols, best practices bulletins and conducted trainings for billing requirements software. · Managed training materials creation and implementation for application software. · Go live support for more than 800 employees corporate-wide. Credentialing Coordinator · Manage entire process of credentialing: data entry and performing primary source verifications in accordance with various regulatory agencies for credentialing or re-credentialing of physicians. · Efficiently credential all initial applicants in a timely fashion. Confirm practitioners’ medical billing knowledge. · Resolve practitioner concerns promptly to advance onboarding speed and/ or to support practitioners’ metrics. Compliance Coordinator · Maintain up to date policies and procedures in order to incorporate them into user trainings and clinical workflow designs, development and assessment. · Routinely partner with Leadership to assemble and distribute major education initiatives regarding regulations/laws pertaining to PHI, ADA, Medicare billing, patient abuse, gun laws, or state requirements that support company metrics achievement.
- COMPLIANCE AND CREDENTIALING COORDINATOR at SLEEPMED INC
16 years, 8 months at this Job
- - Computer Science Technology
- - Practical Nursing Program
Credentialing Coordinator - Complete provider credentialing and re-credentialing applications and follow up as needed in both non-delegated as well as delegated credentialing; work with clients and fee schedules and different payout handling issues; enter and monitor providers information in online CAQH database system; experience with various payors including Medicare, Medicaid, and all commercial payors; Superuser with ECHO and Intellicred (credentialing software); experience with expirables. Complete primary source verification with NPDB/SAM/OIG; verification of licenses, education and work history. Work with W9’s and COI’s; Maintain confidentiality of provider information;
- Credentialing Coordinator at Novant Health / ChoiceHealth
- Scheduling Supervisor, Medical Records Supervisor, Credentialing Agent at ROWAN DIAGNOSTIC CLINIC, PA
- Medical Office Assistant at SALISBURY PEDIATRIC CLINIC
- OR Surgical Technician at ROWAN REGIONAL MEDICAL CENTER
1 year, 11 months at this Job
- HIGH SCHOOL DIPLOMA