Credentialing Coordinator/Payroll Officer
Beneficent Healthcare Services
Houston, Texas
04.2019 - Current
- Conduct comprehensive credential verification for healthcare professionals, ensuring compliance with regulatory and organizational standards.
- Manage the entire credentialing lifecycle, including application processing, document collection, verification, and database maintenance.
- Patient case management, liaising with the patients’ health insurance companies for the type of health insurance they have and the duration of their insurance policies.
- Basic knowledge on HIPAA and writing incident reports
- Developed effective communication strategies between staff, patients, providers, family members and health insurance companies with a high level of customer service physically, on the phone, and with the use of 2067 which is a communication tool with the patients’ health insurance companies while maintaining a friendly and professional attitude.
- Onboarding and Training caregivers, collecting, verifying credentials, and other relevant documentation for health caregivers and creation of schedules for them to work with.
- Verifying and calculating caregivers’ work hours and submitting insurance billing to the patients’ health insurance companies for appropriate credit using both Penni and Turbo applications for bi-weekly payroll and payment.
- Prepare applications, review for completeness and accuracy, and submit to the appropriate state regulatory bodies and health plans.
- Ensure strict adherence to healthcare regulations, state-specific requirements, throughout the credentialing process and coordinating health care programs and progress monitoring.
- Develop and maintain positive relationships with healthcare providers and internal teams, fostering a collaborative and efficient credentialing environment.
- Creating attendant orientation using Vistar application for managing care and health plans of patients to streamline credentialing workflows.
- Keeping updates with Health Insurance Companies for patients’ healthplan care and eligibility.
- Organizing members’ charts/files and ensuring their daily completeness by updating necessary information for proper documentation and state audits.
- Proficiency in Microsoft Office applications.
- Work directly with Staffing/Recruiting to provide updates on clients, providers and team members credentialing status.
