Credentialing Associate Resume Samples

A Credentialing Associate ensures that the medical staff members stay aware of current credentials and licenses that are needed to work legally in the field or specialty. A well-drafted Credentialing Associate Resume mentions the following duties and responsibilities – monitoring upcoming renewal dates, advising medical staff about the steps to be followed to maintain their credentials; reviewing information on potential new employees, maintaining compliance with all regulatory and accrediting institutions, participating in the development of the internal credentialing process, and advising staff on renewal procedures.

Those seeking to make a career in this specialty should be able to embrace the following skills and abilities – staying aware of regulations and standards, knowledge of applicable medical policies, strong computer skills, researching skills, and the ability to interact with other medical professionals. A relevant degree such as Health information management is highlighted on eligible resumes.

 

Credentialing Associate Resume example

Credentialing Associate Resume

Headline : To secure a Credentialing Associate position with a dynamic organisation that will utilise my skills and help both the organisation and myself expand, Managing all customer and employee information, Ensuring policies are followed, and also Managing the on boarding process, Coordinating with finance for payroll, Assisting with data entry of new hires and vendors, Assisting with data entry of new vendors.

Skills : Excel, Microsoft Word, Researching.

Description :

    1. Credential newly recruited physicians, nurse practitioners and all other Allied Health Professionals as well as Independent contractors.
    2. Updated and maintained current information in the (MSL) Medical Staff Line database.
    3. Sent out primary source letter to verify physicians and other allied health professionals degrees and education.
    4. Requested and submitted credentialing applications for hospital privileges for physicians and all Allied Health Professionals.
    5. Changed billing worksheets weekly.
    6. Completed billing worksheets and forward to corporate for billing.
    7. Reported daily census data to corporate collect research data for Vermont Oxford study.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Bachelor's


Credentialing Associate Resume

Headline : Dedicated and focused Credentialing Associate who excels at prioritising, multi-tasking and following through to achieve project goals. Seeking a role with increased responsibility and authority, Assist with data entry of new clients, Verifying accuracy of documents and ensure they follow company guidelines, Tracking all changes in system.

Skills : Resourceful, Detail Oriented, Team Player, meeting deadlines, versatility.

Description :

    1. Responsible for credentialing and re-credentialing activities in the Credentials Verification Center.
    2. Performed primary source verification of practitioners, facilities and providers credentialing information.
    3. Maintained a high level of confidentiality and attention to detail.
    4. Processed initial credentialing applications which include the review of information submitted by providers.
    5. Maintained accurate provider data in CPD and other applications through accurate data entry and verification's.
    6. Assisted leadership in auditing files.
    7. Followed credentialing processes and procedures to improve efficiency and quality of files.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Diploma


Credentialing Associate Resume

Objective : Four years experience on inbound phones in a call center environment. Can take eighty to one hundred inbound calls per day. 40 WPM. Able to learn and use multiple company computer systems at one time, Understanding, implementing and explaining company policy and procedures to clients, Multiple years of retail customer service experience and issue resolution experience.

Skills : Multi-Line Phone System Multi-Tasking Scheduling Much More.

Description :

    1. Credentialed and re-credentialed all clinic providers.
    2. Responsible for all aspects of the provider's renewal packet, prepared files for the meetings, assisted in department projects.
    3. Ran monthly reports request and maintain current licenses and CME's, assists physicians in obtaining other state licenses.
    4. Coordinated the Dental Unit- Obtaining consents,, ordering, working with the dental providers in an administrative capacity.
    5. Organised the credentialing department so all providers files are up to date with all needed documentation according to the Policy and Procedures of the Center.
    6. Used I feel that my functionality and multitasking skills have helped me to accomplish the areas of the position that were needed to be improved upon.
    7. Conducted Provider outreach to obtain information needed for Credentialing Committee review.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
MS

Credentialing Associate Resume

Headline : Credentialing Associate with 5 years of experience in Providing guidance on developing a career path and identifying career markers, such as promotion targets, in order to be recognized as an effective employee, Developing and maintaining a portfolio of professional development experiences that align with the business goals, objectives and strategies of the organization.

Skills : Graphic design, Shipping and receiving, Forklift operation, Adobe Creative Suite, HTML, CSS.

Description :

    1. Responded to medical groups or physicians via telephone and written correspondence regarding provider's eligibility pertaining to credentialing of physicians with Care More, associated health plans and IPA's.
    2. Analysed problems and provides information/solutions.
    3. Operated a PC/image station to obtain and extract information; Documents information, and changes in the database.
    4. Used of excel and excel pivot tables to manage report data.
    5. Maintained positive customer relations with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
    6. Provided external and internal customers with requested information in compliance with CAQH Management/auditing of HDO/SNF case files for Medicare and DHS compliance Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer provider questions..
    7. Analysed and audited the credentialing database records to ensure accuracy.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Bachelor's

Credentialing Associate Resume

Headline : An energetic and ambitious individual passionate about healthcare and personal performance. Able to multi-task. Can offer compassion, productivity and efficiency, Develop and manage a sales pipeline by researching potential clients and prospects, Market products on behalf of the company with written campaign materials, Researching available third party marketing partners to execute campaigns.

Skills : Power Point, Excel, Microsoft Office, Outlook.

Description :

    1. Obtained, reviewed and confirmed all documentation pertaining to a physician and their practice.
    2. Prepared and coordinated information for internal and external contacts.
    3. Confirmed Healthcare network statuses and keep demographic logs for twelve providers.
    4. Completed Healthcare contracts/agreements for providers to become participating providers in the various health networks for billing purposes.
    5. Enrolled providers in the various Healthcare options (Commercial, HMO, PPO, etc.).
    6. Maintained logbooks or records of activities and tasks Created National Provider Identifiers and completed CAQH applications.
    7. Data entered and maintained provider records in Consolidated Provider File database.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
BS In Business Administration

Credentialing Associate Resume

Objective : Credentialing Associate is responsible for assisting the department in the development and maintenance of the company’s credential database. This includes managing applicant tracking systems, managing the database, and ensuring compliance with regulatory requirements.

Skills : Excel, Microsoft, Mediated, Word Processing.

Description :

    1. Identified state and federal requirements for credentialing.
    2. Performed credentialing analysis including legal review of application materials, background checks, and credit checks.
    3. Managed all aspects of credentialing in compliance with state and federal guidelines.
    4. Coordinated with other departments for pre-employment screenings.
    5. Provided support for staffing processes including recruitment, selection, and placement of qualified candidates.
    6. Assisted with the development of new policies and procedures for credentialing.
    7. Provided support to ensure that all current staff are up to date on policies/procedures.
                                Years of Experience
                                Experience
                                2-5 Years
                                Experience Level
                                Level
                                Junior
                                Education
                                Education
                                Bachelor's

                                Credentialing Associate Resume

                                Objective : Results-driven Credentialing Associate professional with a decade of experience utilizing excellent problem-solving skills to deliver ultimate customer service and satisfaction while surpassing company goals, Manage the CRM database by entering new clients into it, updating contact information, adding new products, updating pricing, etc, Developing marketing collateral for events such as press tours or in-person presentations.

                                Skills : Excel, Powerpoint, Avaya, Telephone , Technical Support.

                                Description :

                                  1. Assisted with any projects or initiatives related to credentialing in order to maintain continuous improvement.
                                  2. Maintained a thorough knowledge of departmental policies.
                                  3. Provided guidance on the policies, procedures, and processes of credentialing.
                                  4. Provided guidance on credentialing requirements and changes to them.
                                  5. Provided guidance on activities that are required of the credentialing process, such as background checks.
                                  6. Proactively reached out to customers when there are issues or questions about their credentials and providing guidance on how to resolve them.
                                  7. Supported customers through the process of reissuing their credentials.
                                                              Years of Experience
                                                              Experience
                                                              2-5 Years
                                                              Experience Level
                                                              Level
                                                              Executive
                                                              Education
                                                              Education
                                                              MS

                                                              Credentialing Associate Resume

                                                              Summary : Credentialing Associate with 8 years of experience in Creating and following-up on credentialing process, Performing background checks, Maintaining and updating employee files, Processing new hire paperwork, and also Maintaining HR database of all current employees, contractors, vendors and other credentialed individuals.

                                                              Skills : Troubleshooting, Opera, Adobe, Lotus Notes, Social Networking, Internet Research, Schedule Appointments, Billing.

                                                              Description :

                                                                1. Supported customers through the process of obtaining a new ID card or driving license.
                                                                2. Managed paperwork throughout the process of credentialing, including filling out forms and reviewing documents for accuracy.
                                                                3. Managed and coordinated the credentialing process.
                                                                4. Updated credentials as needed.
                                                                5. Provided support to employees in need of credentials.
                                                                6. Developed standard operating procedures for credentialing.
                                                                7. Developed and maintained forms and templates for use by internal departments.
                                                                                  Years of Experience
                                                                                  Experience
                                                                                  7-10 Years
                                                                                  Experience Level
                                                                                  Level
                                                                                  Management
                                                                                  Education
                                                                                  Education
                                                                                  MS

                                                                                  Credentialing Associate Resume

                                                                                  Objective : To obtain a Credentialing Associate, responsible for Scheduling appointments with clients, Confirming client eligibility and availability, Conducting interviews with potential new hires, and also Processing applications for new hires and existing staff members, Ensuring that staff are properly trained in our process, Maintaining office calendar.

                                                                                  Skills : Managing, Office Management, Database Management.

                                                                                  Description :

                                                                                    1. Worked with vendors to manage credentialing.
                                                                                    2. Verified professional credentials.
                                                                                    3. Managed online verification process for employees, customers, and job applicants.
                                                                                    4. Developed and maintained a database of professional credentials.
                                                                                    5. Responded to customer inquiries about credentials.
                                                                                    6. Maintained information in the credential database.
                                                                                    7. Researched and updated information in the credential database as needed.
                                                                                                                                Years of Experience
                                                                                                                                Experience
                                                                                                                                2-5 Years
                                                                                                                                Experience Level
                                                                                                                                Level
                                                                                                                                Executive
                                                                                                                                Education
                                                                                                                                Education
                                                                                                                                MS

                                                                                                                                Credentialing Associate Resume

                                                                                                                                Objective : As a Credentialing Associate, responsible for Developing credentialing programs and processes, Providing guidance to staff regarding credentialing requirements, Assisting in developing internal standards and policies, Generating reports and documents to support policy development, Assisting with managing credentialing processes across the company.

                                                                                                                                Skills : Reporting, Supervising Skills, Managing.

                                                                                                                                Description :

                                                                                                                                  1. Communicated with internal teams about changes to the database.
                                                                                                                                  2. Maintained records of employee compliance with their credential requirements.
                                                                                                                                  3. Provided documentation on processes in place for employees and job applicants.
                                                                                                                                  4. Maintained records of employee compliance with their credential requirements.
                                                                                                                                  5. Managed company's onsite verification program.
                                                                                                                                  6. Assisted with registration for events and programs to verify that all necessary information has been submitted.
                                                                                                                                  7. Maintained a database of all events and programs for the company.
                                                                                                                                                                  Years of Experience
                                                                                                                                                                  Experience
                                                                                                                                                                  2-5 Years
                                                                                                                                                                  Experience Level
                                                                                                                                                                  Level
                                                                                                                                                                  Executive
                                                                                                                                                                  Education
                                                                                                                                                                  Education
                                                                                                                                                                  GED