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Brad Nguyen
Credentialing Coordinator
Summary
I am a highly motivated and experienced Credentialing Coordinator with over 5 years of experience in the healthcare industry. I have a proven track record of successfully evaluating and processing provider applications for credentialing, ensuring compliance with Joint Commission and regulatory standards. I am also skilled in negotiating and maintaining payer contracts, resulting in increased reimbursements and improved provider relations. I am confident that I have the skills and experience necessary to be successful in this role.
Education
Health Information Management
December 2018
Skills
- Provider Enrollment
- Credential Verification
- Network Maintenance
- Data Analysis
- Customer Service
- HIPAA Compliance
Work Experience
Credentialing Coordinator
- Analyzed provider data and identified trends to stay abreast of industry best practices and regulatory changes.
- Collaborated with medical staff, providers, and administration to ensure alignment of credentialing processes with clinical and regulatory requirements.
- Managed a team of credentialing specialists, providing leadership and guidance to ensure timely and accurate processing of applications.
- Developed and maintained relationships with state licensing boards and credentialing verification organizations for expedited credentialing.
Credentialing Coordinator
- Evaluated and processed over 5000 provider applications for credentialing, ensuring compliance with Joint Commission and regulatory standards.
- Negotiated and maintained payer contracts, resulting in increased reimbursements and improved provider relations.
- Developed and implemented a comprehensive credentialing tracking system, streamlining the credentialing process and reducing turnaround times.
- Trained and mentored new credentialing staff, ensuring a high level of knowledge and expertise within the team.
Accomplishments
- Challenge Streamlined credentialing processes, reducing provider onboarding time by 25%
- Action Automated credentialing verification and data entry using technology, minimizing errors
- Result Improved credentialing accuracy and efficiency, ensuring timely provider enrollment
- Challenge Enhanced credentialing compliance by 15%
- Action Implemented a comprehensive compliance monitoring system, tracking and addressing compliance concerns
Awards
- National Credentialing Association (NCA) Annual Excellence Award for Credentialing Management
- Healthcare Credentialing Association (HCCA) Recognition Award for Outstanding Contributions to Credentialing
- Organizations Annual Award for Excellence in Credentialing Operations
Certificates
- Certified Provider Credentialing Specialist (CPCS)
- Certified Healthcare Enrollment Specialist (CHES)
- Certified Medical Reimbursement Specialist (CMRS)
- Fellow of the American Academy of Professional Coders (FAAPC)
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How To Write Resume For Credentialing Coordinator
- Highlight your skills and experience in evaluating and processing provider applications for credentialing.
- Showcase your ability to negotiate and maintain payer contracts, resulting in increased reimbursements and improved provider relations.
- Emphasize your experience in developing and implementing comprehensive credentialing tracking systems.
- Highlight your ability to train and mentor new credentialing staff.
- Demonstrate your knowledge of industry best practices and regulatory changes.
Essential Experience Highlights for a Strong Credentialing Coordinator Resume
- Evaluate and process provider applications for credentialing, ensuring compliance with Joint Commission and regulatory standards
- Negotiate and maintain payer contracts, resulting in increased reimbursements and improved provider relations
- Develop and implement comprehensive credentialing tracking systems, streamlining the credentialing process and reducing turnaround times
- Train and mentor new credentialing staff, ensuring a high level of knowledge and expertise within the team
- Analyze provider data and identify trends to stay abreast of industry best practices and regulatory changes
- Collaborate with medical staff, providers, and administration to ensure alignment of credentialing processes with clinical and regulatory requirements
- Manage a team of credentialing specialists, providing leadership and guidance to ensure timely and accurate processing of applications
Frequently Asked Questions (FAQ’s) For Credentialing Coordinator
What are the key responsibilities of a Credentialing Coordinator?
The key responsibilities of a Credentialing Coordinator include evaluating and processing provider applications for credentialing, negotiating and maintaining payer contracts, developing and implementing comprehensive credentialing tracking systems, training and mentoring new credentialing staff, and analyzing provider data and identifying trends to stay abreast of industry best practices and regulatory changes.
What are the qualifications for a Credentialing Coordinator?
The qualifications for a Credentialing Coordinator typically include a bachelor’s degree in health information management or a related field, as well as 2-3 years of experience in credentialing or a related field.
What are the career prospects for a Credentialing Coordinator?
The career prospects for a Credentialing Coordinator are good, as the demand for qualified credentialing professionals is expected to grow in the coming years.
What are the key skills for a Credentialing Coordinator?
The key skills for a Credentialing Coordinator include excellent communication and interpersonal skills, strong attention to detail, and a thorough understanding of healthcare regulations and credentialing processes.
What is the salary range for a Credentialing Coordinator?
The salary range for a Credentialing Coordinator varies depending on experience and location, but the average salary is around $60,000 per year.
What are the benefits of working as a Credentialing Coordinator?
The benefits of working as a Credentialing Coordinator include a competitive salary, a stable work environment, and the opportunity to make a positive impact on the healthcare system.
What are the challenges of working as a Credentialing Coordinator?
The challenges of working as a Credentialing Coordinator include the need to stay up-to-date on healthcare regulations and credentialing processes, as well as the need to work independently and as part of a team.
How can I prepare for a career as a Credentialing Coordinator?
You can prepare for a career as a Credentialing Coordinator by earning a bachelor’s degree in health information management or a related field, and by gaining experience in credentialing or a related field.