Credentialing Coordinator Resume Samples

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Credentialing Coordinators ensure the periodic renewal of licenses and credentials held by doctors and nurses. Common job duties highlighted on a Credentialing Coordinator example resume are creating and implementing credentialing processes, processing applications, checking paperwork for accuracy and completeness, and maintaining accurate databases. Those interested in a Credentialing Coordinator position should be able to showcase the following qualifications in their resumes: knowledge of credentialing procedures, accuracy, confidentiality, attention to details, time management, and integrity. Most Credentialing Coordinators hold at least and Associate’s Degree in human resources and are certified with the National Association Medical Staff Services.

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1

Credentialing Coordinator

Completed complicated hospital privileging forms for physicians performing Locum Tenens work in a timely manner

  • Successfully and consistently met deadlines for applications to be returned
  • Achieved 100% of goal in first 3 months when expectations were set for around 6 month mark
  • Learned how to better communicate with a team of people to ensure timely updates
Candidate Info
8
years in
workforce
9
months
at this job
BS
Communication
2

Credentialing Coordinator

  • Guided physicians through the credentialing process and enrolled them into required insurance plans providing coverage for services rendered through their offices and [company name].
  • Responsible for front to back credentialing process which included new employee onboarding, event driver reviews and periodic reviews.
  • Led the process improvement project which reduced credentialing process from 90 to 60 days.
  • Utilized electronic credentialing with CAQH to formulate a more standardized process while following NCQA credentialing guidelines.
  • Provided feedback and notification to physicians, managers, and coordinators regarding acceptance to payor panels in an organized and timely manner.
  • Catalogued all physician practice information, making all necessary changes to physician files, electronic databases and phone directories.
Candidate Info
7
years in
workforce
7
years
at this job
BS
Ba
MBA
Business Adminstration
3

Billing and Credentialing Coordinator

  • Initiated and maintained all Credentialing, Contracting, Licensing and Continuing Education Certificates for all twenty Doctors and Nurse Practitioners.
  • Managed and input daily billing for all six clinic locations.
  • Reconciled all clinic receivables daily, to track monthly revenue goals for all clinics.
  • Awarded bonus for entire department for exceeding billing revenue goals.
Candidate Info
21
years in
workforce
1
year
at this job
4

Credentialing Coordinator

  • Credentialed/Re Credentialed physicians - Verifications, Background checks, etc.
  • Improved and maintained physicians education
  • Revised and created templates, reports, and documents
  • Trained coworkers on data base systems as well as credentialing procedures
  • Helped to improve our Medical Staff Services website
Candidate Info
1
year in
workforce
1
year
at this job
AS
Business To Human Resources
5

Credentialing Coordinator

  • Assisted Anesthesiologists, CRNAs, and Physicians Assistants with credentialing and reappointment applications at healthcare facilities nationally.
  • Prepared monthly reports of assigned hospitals and surgery centers to superiors for review.
  • Maintained all medical license, drug administration, certifications and malpractice insurance for physicians and mid-level providers nationally.
  • Ensured compliance with national standards of quality organizations.
  • Audited, data entered, and preformed primary and secondary source verifications
  • Resolved practitioner concerns in a timely manner.
Candidate Info
9
years in
workforce
3
years
at this job
BA
Healthcare Management
6

Credentialing Coordinator

  • Primary source responsible for verification updating of provider credentialing information
  • Maintained current, accurate, and complete individual provider files
  • Monitored and organized paper files to adhere to NCQA accreditation standards.
  • Reviewed and completed data entry of credentialing information
  • Prepared reports and summaries of all credentialing activities
  • Provider Relations
Candidate Info
10
years in
workforce
2
years
at this job
HS
High School Diploma
7

Credentialing Coordinator/executive Assistant

  • Coordinated primary source verifications of initial and reappointment credentialing applications. Ensured credentialing of applicants for membership and appointment was coordinated accurately and timely in compliance with defined schedules.
  • Provided administrative support to the Vice-President, Administrator, Clinical Manager, Clinical Coordinator and the Business Office Manager.
  • Supervised the business office staff when the management team was out of the office.
  • Maintained policies and procedures and updated as changes or new polices were approved by the Governing Board.
  • Accommodated all departments in the business office as needed, such as, insurance verification, scheduling, collections, medical records and registration.
Candidate Info
14
years in
workforce
4
years
at this job
GED
GED
BA
Healthcare Administration
8

Medical Credentialing Coordinator

  • Reviewed provider files for appropriate documentation required for the credentialing process while assuring NCQA and JCAHO compliance
  • Collected and maintained files in relation to credentialing of network providers, including application, current physician licenses, DEA licenses, malpractices insurance, board certifications and other pertinent forms
  • Maintained credentialing database to ensure data was kept current and accurate
Candidate Info
3
years in
workforce
2
years
at this job
BS
Business Administration
MA
Business Administration
9

Credentialing Coordinator

Process and analyze new/billable provider's credentials in all departments to be enrolled with various insurance payers.

  • Send applications to provider and to payers for signatures, manage a large amount of provider information at one time.
  • Follow up on emails and phone calls with department contacts, enter provider data and follow up information into Symed credentialing database.
  • Resolving audit trails and claims edits through ETM.
  • Following up on provider information with various insurance payers.
  • Training and assisting support reps with online enrollment and verification.
  • Experience with EHR Incentive Program, CAQH Provider Database, New Provider Enrollment, ETM through IDX System
Candidate Info
4
years in
workforce
1
year
at this job
BS
Management Of Human Resources
MS
Business Management
10

Credentialing Coordinator

  • Coordinated and set up meetings, interviews, phone interviews and helped manage the schedule of various employees
  • Worked with Clients/hiring managers to get the candidate closed and hired
  • Managed all compliance and policy for our branch
  • Stayed up to date on contract specific documents for different facilities and tracked credential
Candidate Info
2
years in
workforce
1
year
at this job

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