Credentialing Assistant Resume Samples

Working in the health-care field, the Credentialing Assistant will take responsibility for assisting the physicians by preparing and submitting various credentialing applications. Typical duties described on the Credentialing Assistant Resume include – preparing and submitting credentialing applications; following-up the status of the application, keeping a detailed log of all pending and finished work, communicating the results of the application to the physicians, and payers; updating credentials of every employee; filling and auditing documents, and ensuring the credentials are up-to-date.

Employers want candidates possessing the following characteristics – good computer skills, telephone skills; prior work experience in healthcare or medical-related fields; working knowledge of word processing and spreadsheet software; and familiarity in using fax and copy machines. It is mandatory for applicants to have a high school diploma and medical office experience in order to gain this job.

Credentialing Assistant Resume example

Credentialing Assistant Resume

Headline : Experienced and highly motivated administrative professional seeking a rewarding and challenging position. Strong verbal and written skills, assist with a variety of complex tasks in an efficient manner and maintain order in the workplace. Expert in Microsoft Office Suite and Microsoft SharePoint. Extensive knowledge both in speaking and writing in Spanish. NACLC Clearance.

Skills : Allscripts, Microsoft Office, Typing.

Description :

    1. Reviewed provider files for appropriate documentation required for the credentialing process.
    2. Coordinated re-credentialing applications and conduct document research.
    3. Submitted applications to credentialing specialist, manager, and Credentialing Committee for review.
    4. Communicated with providers and field associates regarding credentialing status and information.
    5. Reviewed applications for completeness and confidential information collection, verification and documentation in accordance with established policies and procedures for continuous credentialing and recredentialing of providers.
    6. Collaborated with department management the streamlining and updating of credentialing processes.
    7. Closely monitored information collection and is cognizant of all information received; evaluates adequacy and quality and pursues additional information if necessary for effective and comprehensive peer review decision-making.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Inspector General


Sr. Credentialing Assistant Resume

Summary : To work in a challenging and stimulating environment with opportunity to use current experience and to enrich knowledge and enhance experience. To contribute towards the achievement of organizational objective by applying professional skills.

Skills : Extensive Customer Service Experience Money Handling Experience Experience in professional and office settings.

Description :

    1. Responsible for all functions related to healthcare worker and other contractor staff credentialing, re-credentialing and privileging in accordance with regulatory/compliance guidelines as well as IHSC requirements.
    2. Responsible for obtaining and verifying credentials, certifications, state licensures, and other professional credentials as well as maintaining on-going checks to ensure that all credentials remain current.
    3. Responsible for the accuracy and integrity of the credential/privileging files, whether in hard copy or electronic form.
    4. Initiated and followed through on all aspects of the credentialing process, including initial and re-credentialing, for all healthcare and other staff as needed.
    5. Prepared and generated healthcare worker and other staff credentialing/privileging packets and provides guidance to ensure timely completion.
    6. Conducted various background checks from a wide variety of sources as needed to verify the credentials and suitability of candidates, including but not limited to: NPDB, OIG/GSA, National Sex Offender Registry, and the National Student Clearinghouse.
    7. Maintained new hire as well as on-going credential files for IHSC staff, and makes them accessible as needed.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Technology


Jr. Credentialing Assistant Resume

Objective : To secure a challenging position that will utilize and build on academic training and past experience.

Skills : 14 years experience in a fast paced Medical Office, Health care field.

Description :

    1. Assisted in analyzing, and implementing the health care provider's Credential Review/Privilege Program.
    2. Gathered, analyzed, and verified information on medical education as well as specialized training of all practitioners who request hospital privileges and verification.
    3. Supported a group of over 280 current trainees, hundreds of training verification requested each year, and all incoming trainees each year.
    4. Consistently coordinated the verification process with agencies both INCONUS and OUTCONUS.
    5. Reviewed contractor's verification of all education, training, and license for prospective employees.
    6. Verified all background information used in establishing a provider's bona fide medical expertise.
    7. Researched, analyzed, and prepared reports for placement in individual credential files or professional files.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Business Administration

Credentialing Assistant III Resume

Headline : A position where experiences can broaden while being utilized to promote your company's success.

Skills : Inventory Management, Organization, Stocking, Computer , Communication , Data Entry, Warehouse.

Description :

    1. Managed important documents related to doctors that were joining our company.
    2. Worked on the computer, overseeing emails and updating information.
    3. Able to effectively communicate information to large groups.
    4. Able to quickly adapt to any situation.
    5. Prepared credentialing welcome letters and mail out to all approved providers.
    6. Provided assistance in the Performance Appraisal Systems (PARS) and Clinical Appraisals System (CARS).
    7. Possessed superior knowledge of medical and scientific terminology and skills to create, maintain, and update hard copy files as well as electronic files.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Technology

Credentialing Assistant II Resume

Summary : To secure a position with a well-established organization with a Stable environment that will lead to a lasting relationship in the Field of Data Entry/Customer Service. To obtain a position that will Enable the use of strong organizational skills, Microsoft Expertise and ability to work well with people.

Skills : Medical Staff Management, Credentialing, Risk Management, Administrative, Management, Leadership, Healthcare.

Description :

    1. Prepared, sent and processed re-appointment applications.
    2. Assisted with provider enrollment with payer companies, track provider enrollment effective dates.
    3. Worked knowledge and used of Intellicred software.
    4. Tracked expirables such as license, DEA, board certification, COI's.
    5. Assisted with Anesthesia billing problems.
    6. Provided Hospital Affiliation response letters.
    7. Attended and recorded Hospital Credentials Committee Meeting minutes.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Bachelor Of Science

Credentialing Assistant I Resume

Objective : To secure a position in the Health Care Industry with the potential for advancement.

Skills : Siemens Database, Invision, Medassets, Supervisory , Strong Communications, Microsoft Word.

Description :

    1. Responsible for coordinating and updating doctors insurances.
    2. Responsible for administrative duties including photocopying all documents and filing.
    3. Coordinated and organized business meetings between doctors and representatives.
    4. Responsible for all mail, all phone calls, and taking messages.
    5. Used Excellent written and communication skills.
    6. Able to multi-task and work under tight deadlines.
    7. Highly organized and detailed orientated.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
BA In Hospitality

Credentialing Assistant/Administrator Resume

Objective : Highly qualified Credentialing Assistant with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and would excel in the collaborative environment on which your company prides itself.

Skills : Microsoft Office, 10-Key, Customer Service, Spreadsheets, Typing.

Description :

    1. Re-credentialed physicians and allied health professionals for twenty-nine (29) facilities.
    2. Initiated, processed, reviewed and analyzed significant amounts of verification and accreditation information including applications, education and residency, Continuing Medical Education (CME), board certifications and eligibility, contracts, licensures, DEA/STNA licenses, liability insurance including malpractice claims.
    3. Forwarded applications to providers and ensured accuracy and completeness of information.
    4. Generated data reports for expirations of licenses, certifications and board certifications on a monthly basis.
    5. Maintained close communications with all appropriate practitioners to ensure that records are up-to-date and consistent.
    6. Interfaced between providers and Medical Staff Offices (MSOs) to collect required information.
    7. Worked with Finance to obtain Re-credentialing fees for the facilities.
    8. Internally audited, organized and maintained provider files in accordance with established principles of legal documentation and confidentiality.
    9. Identified and flagged adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for Hospital Committee review.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Diploma

Associate/Credentialing Assistant Resume

Summary : Energetic office support professional offering exceptional organization and customer service, strong multi-tasking abilities and great time management skills to meet a variety of deadlines while never sacrificing quality or precision.

Skills : Office Organization, Microsoft Office, All Programs, Credentialing, Texas State Notary, Hyperlink Spreadsheets.

Description :

    1. Duties included but were not limited to, prepping Recredentialing files by reviewing applications and attachments for required information and that no licensing, Malpractice Insurance or certifications were expired.
    2. Responsible for running a number of reports against each applicant's licensure such as NPDB, AMD, AOA, OIG, EPLS and the Health Professions Bureau verification for the state each was licensed in.
    3. Worked with the providers or their designated assistant to obtain any missing documentation.
    4. Completed files were then presented at our monthly Credentialing meeting for approval by our Committee.
    5. Required preparation for the peer review and were assessed on a case by case basis.
    6. Contained in files that required a peer review were very sensitive in nature and extra measures were taken to ensure the provider's confidentiality.
    7. Responsible for the monthly mailing of all approval letters once providers were approved by the committee and that was an average of 200+ letters sent each month.
    8. Responsible for mailing out requests for recredentialing packets to providers, filing, numerous phone calls and e-mails.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Technology

Credentialing Assistant/Manager Resume

Headline : To secure a position in which can apply current experience in customer service and gain further exposure and knowledge in the business industry.

Skills : Microsoft Word, Data Entry, Customer Service, Filing, Customer Service, Team Building, Computer.

Description :

    1. Posted of payments, adjustments and charges to complete reconciliation each day, new patient registration and updating patient registration, .
    2. Responsible for answering the department phone line, assisting physicians with the medical credentialing process, reviewing physician .
    3. Assisted in the department gaining NCQA certification and accreditation, and oversaw all recredentialing processes.
    4. Assistanted to the Credentialing Director, Creation of physician Curriculum Vitae 's, Federal and Clinical trial paperwork/contracts amongst the .
    5. Ensured they contain evidence of all certifications required, including training requirements.
    6. Responsible for updating and maintaining the currency of all credential files.
    7. Validated health care provider credentials by verifying undergraduate and post-graduate education.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Graduated

Credentialing Assistant Resume

Summary : Ensured that all providers in the network had current state licenses as well as updated malpractice insurance.

Skills : Computer Programs: Microsoft Word, Excel, Outlook, Allscripts, Kronos.

Description :

    1. Received/audited therapist's application request for group inclusion.
    2. Communicated any required documents and/or missing data to the therapist and Program Directors.
    3. Utilized commercial insurance websites to initiate a credentialing contract on behalf of the therapist.
    4. Received/documented approved therapist's contracts.
    5. Assisted with annual re-validation of facility location data.
    6. Confirmed therapist credentials upon request from insurance companies.
    7. Contacted insurance companies to verify patient's Medicare, Medicaid, and commercial insurance benefits.
    8. Reported eligible benefits back to facility program director as well as documented and maintained accurate comprehensive data for billing and claims.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Bachelor Of Arts