I am a credentialing specialist help with office staff duties. I credential all of the new providers that are hired. I fill out, fax and file all paperwork associated with the applications. Also, I help with scheduling new and re-occurring clients.
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- bachelor's degree in Social Work - Social Work
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- Credentialing Analyst for a FQHC at SWLA Center for Health Services
5 months at this Job
- Bachelor of Science degree - Psychology
- Certified Medical Coder Certification
- Associate of Science degree - Technology
Credentialing Specialist end processor release to Medical Staff Specialist for medical board approval.
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- Sales & Marketing Coordinator to the CEO, Flex Account Specialist, COBRA Insurance Program Manager at MEDCOM
5 months at this Job
- AA - General Education/Business Administration
- - Business Administration Program
• Verify Healthcare Credentials
• It is up to the Credentialing Specialist to ensure that all necessary licenses and credentials are verified and updated for the healthcare facility in which they work. This might include conducting background checks, contacting licensing boards, reviewing license applications, obtaining education information and interviewing references.
• Review Applications and Resume
• A Credentialing Specialist can assist with the new-hire process by going over information contained in job applications and resumes. They can help to ensure that applicants meet all licensing and credential requirements for the healthcare industry and for the specific position that is being applied for.
• Assess Facility Practices
• To ensure that a healthcare facility is operating within state and federal regulations, a Credential Specialist will review the ways in which services are being handled. They will also review facility-specific rules and regulations for compliance with internal processes.
• Maintain Databases
- Credentialing Specialist at Wipro
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- Customer Service Representative at RYLA TELESERVICES
- Account Executive at FIRST DATA MERCHANT SERVICES
10 months at this Job
- Associate - Business
- High School Diploma
Mt Pleasant SC
July 2013- Present
● Compliance: Make sure we are compliant with all state and federal rules & regulations. Kept all business licenses and accreditations for all locations current. Made sure we have all state permits current to ship products into the states we service. Make sure all patient files are complete and compliant.
● Credentialing Specialist: Keeping up with all insurance contracts and making sure we revalidate. Seek out new insurance plans to get in network with and obtaining any required licensing.
● Processor: Process incoming patient orders (patient information data entry, insurance research and compliance, preauthorizations. etc) Billing insurance transactions for supplies shipped sending out fax confirmations to the centers, communicating with nursing staff to ensure all orders are filled properly. Processing self-pay orders, answering 80+ call on a multi-line phone system helping pt and nurses resolve any issues.
- Credentialing Specialist at Tidewater Medical, Inc
- Front desk coordinator at Seaside Pediatrics
- Call Center Manager at Family Savers Inc
5 years, 6 months at this Job
Credentialing specialist for Texas Health Physicians Group, which includes more than 1000 physicians, physician assistants, nurse practitioners and medical professionals. Duties include supporting Practice Managers and assisting THPG providers with health plan enrollment and hospital privileges; while closely observing the activity and assisting managed care plans/medical staff office when necessary. Responsibilities include providing support to Human Recourses and Recruiting to expedite the onboarding process. Additional tasks involve monitoring license and board certifications expirations, APP/Physician agreements, provider moves, transfers, address changes and terminations.
- Credentialing Specialist at Texas Health Physicians Group
- Credentialing Specialist at Universal Health Services
- Credentialing Specialist at PSR, an Intermedix Company
- at Back/Front Medical Office
2 years, 6 months at this Job
- AAS in Medical Staff Services - Medical Staff Services
Credentialing Specialist: I assist with on-boarding by processing, and scheduling background screens, processing personnel information, following up on new hire paperwork and processing, data entry into various HR systems internal customer service to the Field Regional Directors, Metro District Managers and District Managers. *Created quick reference guild for sending chain of custody forms to candidates
- Credentialing Specialist at Mom365
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- Physician Recruiter at Adecco Employment Services, Centene Corporation
2 years, 6 months at this Job
- Some college
Prepare credentialing and re-credentialing applications on behalf of physicians/providers for submission to managed care companies and other agencies.
➢ Ensure demographics/spreadsheets are prepared/complete for application processing to managed care organization specifications
➢ Maintain necessary logs, lists, records, and current documentation required for physician/provider credentialing and re-credentialing to ensure requirements are met in a timely manner.
➢ Received positive recognition for being able to learn and adapt quickly.
- Credentialing Specialist at Newport Credentialing Solutions
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- INTERNSHIP at SUNY Canton
6 months at this Job
- B.B.A - Business Management
Create and maintain provider credentialing files within credentialing database. Verify that appointees have met all requirements and are eligible for staffing within their category. Conduct state licenses, board certifications and background checks. Investigate work history, competency, malpractice and health statuses. Communicate with healthcare providers, Medical Staff Offices and Office Managers and team members Comply with the guidelines of The Joint Commission and applicable state and federal laws governing credentialing
- Credentialing Specialist at Ultimate Revenue Billing & Credentialing Services
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- Certified Medical Assistant at Eastland Women's Clinic
2 years, 8 months at this Job
- Certificate - Medical Assistant
- Associate - Applied Science
The primary task as credentialing specialist at Parkwest Medical Center was to ensure that healthcare professionals MD's DO's, DPM's, Advance Practice Providers meet all established federal, and state standards as well as Joint Commission and NCQA, have a working knowledge of hospital bylaws, rules and regulations and hospital committee requirements, process and accuracy, maintain provider database for practitioners and hospital to include education, past hospital affiliations CME's licensure as well as communication with physician's offices and hospital professionals to ensure all records are current. In addition to credentialing specialist duties consisted of, preparing monthly reports for corporate and hospital administration and outside agencies. Responsible for coordination of all physician related events to include department meetings, agendas, meeting notices and follow-up, monthly meeting calendar, assist physician department chairs with researching criteria for new hospital privileges, audit credentials files for committee review and approval, respond to outside and in-house inquiries regarding physician's and advance practice providers staff status and privileges, maintain credentials files for Joint Commission and State surveys and other duties assigned.
- Credentialing Specialist at Parkwest Medical Center
- Receptionist /Patient Scheduler at University Orthopedic Clinic
- Corporate Credentialing Specialist at Covenant Health
- Gift Shop Coordinator Supervised at Fort Sanders Regional Hospital
3 years, 11 months at this Job
- - Elementary Education
- - Medical