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YOUR NAME
123 Any Street
Any Town, USA 55555
(555) 555-5555
123email@anyprovider.com
CREDENTIALING
COORDINATOR / SPECIALIST
Offering:
-
Ten years
of credentialing experience working in corporate and
healthcare office environments.
- Expertise in
coordinating provider applications and the
re-credentialing process.
-
Solid
knowledge of NCQA and DHS credentialing standards.
-
Proven
ability to work independently and efficiently with
superior results.
PROFESSIONAL EXPERIENCE
Company, Town, XX
Date - Date
Credentialing Specialist
- Review provider files for
appropriate documentation required for the credentialing
process.
- Prepare files for audits
and maintain electronic data input activities.
- Coordinate credentialing
and re-credentialing applications and conduct document
research.
- Collect and maintain files
in relation to credentialing of network providers, including
application, contracts, current physician licenses, DEA
licenses, malpractice insurance, board
certifications and other pertinent forms.
- Prepare documents for
Credentialing Committee review.
- Forward applications to
providers and ensured accuracy and completeness of
information.
- Interface between
providers and hospital staffs to collect required
information.
- Perform credential
verification and request information from appropriate data
banks.
- Submit applications to
manager, medical director and Credentialing Committee for
review.
Company, Town, XX
Date - Date
Credentialing Coordinator
- Implemented and
monitored procedures and activities related to
credentialing and re-credentialing of network providers.
- Communicated with
providers and field associates regarding credentialing
status and information.
- Assembled and prepared
credentialing information for appropriate committees.
- Received Managed Care
and PPO provider applications and re-credentialing
applications.
- Maintained and updated
database to track applications and the credentialing
process.
- Provided
administrative support such as generating and
distributing mailings.
- Participated in the
appointment process and coordinated medical staff
meetings.
EDUCATION
University, Town, XX
B.S. in Business Administration
COMPUTER SKILLS
MS Word, Excel, Access; SweetQ and Philprov
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