Experienced Credentialing Specialist adept at conducting application reviews and primary source verifications. Excellent relationship-building, problem-solving and communication skills.
Overview
4
4
years of professional experience
Work History
Patient Service Representative II
Sutter Health Medical Foundation
12.2022 - Current
Provided exceptional customer service to patients, answering questions and addressing concerns.
Verified insurance eligibility and coverage for patients.
Entered patient demographic and insurance data into electronic medical record system.
Filed and maintained patient records in accordance with HIPAA regulations.
Worked Closely with Providers
Credentialing Specialist
Luna Physical Therapy
12.2020 - 12.2022
Conducted primary source verifications such as background checks and board certifications.
Prepared records for site visits and file audits.
Obtained NPI numbers for providers and facilities and updated existing profiles.
Received and evaluated applications to look for missing and inaccurate information.
Worked Directly with providers and staff on polices and Procedures
Able to effectively work with provider while also upholding company standards
Expectional communication skills and attention to detail
Managing Director
Elixir Muscle Recovery
10.2019 - 11.2020
Oversaw operations and provided corrective feedback to achieve daily and long-term goals.
Monitored office workflow and administrative processes to keep operations running smoothly.
Introduced new methods, practices, and systems to reduce turnaround time.
Worked closely with organizational leadership and Physicians