Provider Credentialing Specialist Resume Example Axis Employment Services LLC

PROVIDER CREDENTIALING SPECIALIST

Summary

Talented secretary adept at managing complex responsibilities in high-volume settings. Resourceful and proactive with strengths in building professional, focused teams. Seeking to use advanced experience and skills to improve department efficiency, accuracy and productivity in busy managed-care environment.

Superb in Customer Service and skilled at balancing customer needs and company demands. Effectively builds loyalty and long-term relationships with customers while achieving all individual sales goals.

Knowledgeable Credentialing Specialist successful at performing application checks and verifying provider information at primary sources like discipline governing boards. Good relationship-builder, skilled communicator and complex problem-solver looking for a fast-paced role at TriWest HealthCare Alliance.

Skills

Employee development and management
Mentoring and training
Teaching and learning assessments
Curriculum development and oversight
Invoicing and receipts
Strong organizational skills
Analytical abilities
Call control skills
Performance monitoring
Communicating with clients
Interpersonal skills
Professional telephone voice
Report preparation

Vital sign assessment
Field patient assessments
Emergency management
Calm under pressure
Strong communication skills
School improvement committee
Professional demeanor
Learning management system proficiency
Data-driven instruction
Safety understanding
Team collaboration
Reporting requirements

Experience

02/2019 to Current

Provider Credentialing SpecialistAxis Employment Services LLC － Phoenix, AZ

Performed primary source verifications such as criminal histories, licenses and board certifications.
Checked applications for missing information and organized all paperwork.
Developed process improvements and streamlined procedures to effectively resolve employee discrepancies.
Interpreted, explained and enforced human resources policies to keep staff in compliance with standards.
Created and implemented highly effective and individualized human resource solutions for clients.
Diminished obstacles and saved time, spearheading special projects through effective emergency resolution.
Completed enrollments into Medicaid, Medicare and private insurance plans.
Set up NPI numbers for providers and facilities and updated current profile information.

01/2017 to 11/2017

Head Director of OperationsCalvary Kids Learning Center － Ginowan, Okinawa, Japan

Planned and facilitated relevant, needs-based professional learning tools, resources and educational materials to enhance teaching skills.
Partnered with administrative leadership to improve discipline practices based on data findings.
Set up repair appointments with service professionals.
Took full advantage of upsell opportunities with new and potential customers.
Answered customer/parent requests with friendly, knowledgeable service and support.
Managed a staff of staff members and teachers.
Followed all policies and procedures in preparation of the school budget and disseminated it to all school board members.
Verified achievement of educational program objectives and standards through continual performance monitoring and evaluation.
Cultivated strong student and parent relationships to help resolve situations and positively affect behavior, as well as academic performance.
Monitored the details in regards to student discipline.
Developed a platform for instructional practices design through data-driven decision making.
Met with, hired, oversaw and provided guidance to all school employees while giving feedback.

06/2014 to 12/2016

Medical TechnicianCamp Foster Naval Hospital － Ginowan , Okinawa Japan

Assessed emergency situations and prioritized medical care accordingly.
Executed reasoned and logical decision making in emergent situations.
Maintained complete confidentiality in accordance with organization and legal requirements.
Consistently served as a liaison between collecting agencies and medical facilities.
Kept department clean, organized and professional.
Scanned incoming documentation.
Designed improved training procedures to help new staff acclimate quickly.
Consolidated diverse medical records.
Entered information on computerized systems to verify locations and notify nearest responders.
Certified in CPR to provide First Point of Contact emergency assistance to callers.
Executed proficiency in digital telephone systems.
Prioritized responses to public emergency and non-emergent calls to efficiently dispatch police, fire and EMS while tracking data in real-time.
Completed enrollments into Medicaid, Medicare and private insurance plans.
Performed primary source verifications such as criminal histories, licenses and board certifications.
Checked applications for missing information and organized all paperwork.
Verified and updated account information in company computer system.
Identified and corrected data entry errors to prevent duplication across systems.

Education and Training

2016

Medical AssistanceTexas A&M University - Kingsville － Kingsville, TX

06/2013

High School DiplomaPocono Mountain West High School － Pocono Summit, PA

Resume Overview

Companies Worked For:

Axis Employment Services LLC
Calvary Kids Learning Center
Camp Foster Naval Hospital

School Attended

Texas A&M University - Kingsville
Pocono Mountain West High School

Job Titles Held:

Provider Credentialing Specialist
Head Director of Operations
Medical Technician

Degrees

Medical Assistance
High School Diploma

Provider Credentialing Specialist Resume Example

Resume Score: 80%

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