Reliable and highly skilled Credentialing Anaylst with broad and deep knowledge of the healthcare industry. Extraordinary professional communication skills with staff, patients, and relevant government regulators. Able to function well as an independent worker or as part of a medical insurance team, and clerical team.To expand my Credentialing Analyst Skills and enhance the company's productivity in the health field.
Sending and receiving recredentialing applications for all providers including but not limited to Primary Care Physicians, Specialists, Ancillary Providers, Facilities and any Delegated Entity participating with Carefirst Blue Cross Blue Shield Health Care. Keep an accurate log of providers who have and have not sent in their recredentialing application.
Prepare the recredentialing schedule that will work at the very least, 3 months in advance of when a provider will become up for recredentialing. Ensure that this schedule is adhered to at all times.
•Generate and prepare all recredentialing applications and cover letters to be sent out in a timely manner.
•Keep an accurate log of who has and has not sent back their recredentialing application.
•Initiate the termination process if it is deemed necessary by facilitating the written notifications to be mailed by the Credentialing Supervisor.
•Become familiar with CAQH web-based program used for housing Credentialing Information. Add, Delete and enlist providers to Citrus Health Care's roster so that accurate credentialing and recredentialing files can be maintained.
•Keep current records such as: medical licenses, board certifications, DEAs, and proof malpractice insurance.
•Mail out any and all letters to request updated licensure information.
•Research and verify tax ID numbers, primary office addresses, office hours and provisions for after hours care, and all other necessary provisions for recredentialing.
Geriatric Nursing Certificate
Advanced skills credentialing ,behavioral health, billing, Excellent communication, contracts, CPT, customer service, customer service skills, data entry, database, ICD-9, inventory control, letters, Mental health, exchange, Mail, network, Operational Data Store, ODS, outpatient care, Pharmacy Technician, prescribe, primary care, Quality Management, reporting, research, supervision, telephone etiquette
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