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Trihealth - Credentialing Coordinator Resume Example

Resume Score: 60%

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CREDENTIALING COORDINATOR
Professional Summary
I am a credentialing coordinator who continually maintains a positive attitude while interacting with the demands of billing clients. Serves as the primary point of contact for both in-house and external phone and website queries for credentialing. 

I am a person who goes above and beyond basic tasks, and am capable of taking on multiple projects at once. I have an Excellent work ethic and strength in boosting company morale. I work as a motivated team member to increase revenue for the organization.

I am Quality-focused committed to approaching tasks with tenacity and attention to detail.

The personal experience and growth in my current position has given me opportunity for advancement in many areas of the work force.
Skills
  • Excellent communication skills
  • Accurate and detaile oriented
  • Excellent planner and coordinator
  • Works well under pressure
  • Professional phone etiquette
  • Team building
  • Critical thinker
  • Proficient in MS word, Excel, Powerpoint
  • Understanding of Clearinghouses and billing systems communications
  • Strong Problem Solving Skills
  • Project Time Management Skills
  • Excellent ability to adapt to difficult situations.
  • Multi Tasking
  • Highly dependable
  • Leadership skills
  • Strong ability to obtain and process information
  • Familar with Billing systems, Athena, Misys,Epic
  • Have worked with Quadax and Zirmed clearing houses
Work History
Credentialing Coordinator, 07/2008 to Current
Trihealth – 4600 Wesley Ave 45212, OH

When I was hired for this position it was a newly created position.  Since my start in this position I have developed and continued to show growth in the credentialing position. 
Act as a liaison between billing groups, IT and clearinghouses.
Prepared billing correspondence and maintained database to organize billing information.
Collaborate with the multiple departments to facilitate and coordinated information for provider's insurance enrollment for group and individual providers.
I encourage creative thinking, problem solving, and empowerment as part of the group to improve morale and teamwork.
Achieved high staff morale through effective communication, prompt problem resolution, proactive practices and facilitating a proactive work environment.
Developed and implemented value-added strategies for the credentialing process to increase revenue. Planned and coordinated meetings, committee meetings and staff events with insurance representatives to open lines of communication, and provide billing staff with additional information as a tools for their position.
Helped distribute payer notices and mail provider updates around the office.
Maintained good communication between department heads, medical staff,  by attending meetings and synchronizing interdepartmental functions.
Compiled company information and related material and distributed it to insurance representatives for practice, or provider information changes, and updates.
Routinely collaborated with department managers to correct problems and improve services.
Monitored timelines and flagged potential issues to be addressed.
Defined clear targets and objectives and communicated them to other team members.

Medical Biller, 11/2006 to 07/2008
Trihealth Physican Practices – 4600 Wesley Ave. 45212, OH

    Diligently filed,and followed up on insurance claims.
    Maintained strict patient confidentiality.
    Responded to correspondence from insurance companies.
    Precisely evaluated and verified benefits and eligibility.
    Identified and resolved patient billing and payment issues.
    Confidently and adeptly handled claim denials and/or appeals.
    Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.

PCA- Registrar, 10/2004 to 10/2005
The Health Alliance – Cincinnati, OH
Followed HIPPA guidelines in patient care. 
Corresponding, and following guidlines for commerial insurance payers, Workers Compensation, Medicare and medicaid, to improve revenue. 
Answer phone and schedule patient appointments.
Data entry patient information, and registration.
Registrar Clerical Representative, 01/2001 to 10/2004
The Health Alliace- Spectrum Rehab – Cincinnati, OH
Answer and manage multi-line phone.
Schedule patient appointments
Data entry of patient charges and daily preparation of patient charts.
corresponding dn following guidelines for commercial insurance and workers compensation, and governmental payers to improve revenue.
reconciles billing issues.
Sales Representative, 08/1999 to 01/2001
Western Southern

Maintained current book of clients.
Cold called
Prospecting
scheduling appointments for new sales and maintenance of current clients.

Education
Associate of Science: Science, 2008
Cincinnati State and Community College - Cincinnati, OH
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Resume Overview

Companies Worked For:

  • Trihealth
  • Trihealth Physican Practices
  • The Health Alliance
  • The Health Alliace- Spectrum Rehab
  • Western Southern

School Attended

  • Cincinnati State and Community College

Job Titles Held:

  • Credentialing Coordinator
  • Medical Biller
  • PCA- Registrar
  • Registrar Clerical Representative
  • Sales Representative

Degrees

  • Associate of Science : Science , 2008

Where can I find a Trihealth Credentialing Coordinator resume example in Amelia, Ohio ?

This is an actual resume example of a Credentialing Coordinator who works in the Office Management Industry. LiveCareer has 77707 Office Management resumes in its database. LiveCareer’s Resume Directory contains real resumes created by subscribers using LiveCareer’s Resume Builder.

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