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Insurance Administrative Assistant

Location:
Las Vegas, Nevada, United States
Salary:
14.00 per hour
Posted:
May 16, 2019

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Resume:

Jerry Ballow

**** **** ******* ** #****

Las Vegas, Nevada 89128

702-***-****

ac9eax@r.postjobfree.com

Work Experience

Credentialing Specialist

Medical Revenue Solutions-Henderson, Nevada

**/****- 02/08/2019

Credential clients for all insurances and hospital privileges initial and reappointments

Update medical licenses, DEA, State Pharmacy Malpractice, CME’S

And update hospitals and insurances with renewals.

Research billing problems that have to do with credentialing and update the physician as billing department

Load all provider demographics into Wybtrak Software and print out insurance forms tagging, sending to provider for signature and to insurance company for processing. follow-up on already sent applications

Keep clients and clinics updated with credentialing process

Credentialing Specialist

University of Nevada School of Medicine-Las Vegas

8/2012-06/2017

Credentialed the OB/GYN Department for Hospital privileges and insurance plans initial and reappointment

Keeping logs for effective dates for insurance companies and keeping the OB/Gyn clinics updates with eff dates

Renewing Medical, DEA. State Pharmacy Cert, CME’S, Malpractice and sending all renewals to insurance companies and hospitals

Answer phone calls from providers and hospitals also transferring calls to whom they belong to

Send out new provider packets to collect all their demographics to upload into our Credentialing Software Wybtrak for printing forms, tagging and sending out for signatures

Update the database with all new renews and reprint apps when needed for insurance and hospital processing

Keep CAQH AND HCA updated with new providers and when CAQH sends out their emails sending all required and replacing documents

Credentialing Specialist

Healthcare Business Solutions-Las Vegas

06/2007-07/2011

Credential providers (clients) with all insurance plans and hospital privileges initial and reappointment

Keeping a log of effective dates and status of applications and keep provider updated until completion also collect any extra information to complete his application

Update the database with demographics to print out all his applications send out for his signature

Sending the provider, a new packet and collect all his documents (medical licenses, DEA, State Pharmacy, Malpractice Cert and history, Education, CME’s0 to upload into database

Update CAQH & HCA and alert all hospitals with any changes

Use of Wybtrak Tracking Software

Administrative Assistant/Credentialing Specialist

IPC of Nevada-Las Vegas

01/2005-05/2006

Assist all new providers joining the group with all paperwork and there needs

Answer all multi-phone lines and transfer to department as well as the Executive Director of IPC also set up all video calls also assist the Business Developer

Assist with all meeting between Executive Director and Business Developer perform all secretary duties

Give out welcome packets to all new providers assist then with all information and have them sign all paperwork to credential them as well as all packets paperwork going to main office.

Collect all paperwork to upload into system to print out all insurance and hospitals that the Executive Director wants them to go to

Use of VISTAR Credentialing Soft ware

Answer to Executive Director and Business Developer

Credentialing Specialist

Pinnacle Health Systems (Summit Medical Group)-Las Vegas

02/2002-12/2004

Credential physicians for insurance plans and hospital privileges both initial and reappointment

Renew all medical licenses (DEA, State Pharmacy, Malpractice) update database and send out to all hospitals and insurance companies, Also update CAQH database

Credential and handout welcome new hire packets new physicians and providers joining the group assist with processing and questions he/she may have

Keep all clinics updated with Credentialing logs and grids of any and all changes

Use of Wybtrak Tracking System

Credentialing Specialist

Anesthesia Associates (MK Billing-Henderson

04/2001-02/2002

I also worked here 02/199*-******

Process multiple applications for insurance and hospital initial an reappointment

Update all licenses (DEA, State Pharmacy, Malpractice) send out to all insurance companies and hospital and update CAQH

Answer all calls coming into office and transfer also researching billing questions that are about credentialing

Keep log of status and sending out to providers

Track all applications for processing

Use of Wybtrak Tracking System Software

Credentialing Specialist

Gastro Center of Nevada-Las Vegas

06/2000=04/2001

Process multiple network insurance forms and update all provider licenses (Malpractice, DEA, State Pharmacy) update database and CAQH

Process all new provider applications and upload into database

Keeping all clinics updated with an insurance grid and how process going with new providers

Answer all incoming calls having to do with Credentialing

Use of Wybtrak Tracking System

Credentialing Manager

University of Nevada School of Medicine-Las Vegas

11/1997-11/1998

Handwritten all insurance and hospital applications both initial and reappointment (till Wybtrak was purchased by School)

Send out all insurance applications out for processing and hospitals follow-up with calls to see how process was going

Update database with all renewals and print new applications enter all information into system

Tag application send to physician for signatures and answer all questions on application look over send out for processing

Use of Wybtrak Tracking System

Client Rep/Prior Authorization Representative

Nevada Preferred Professionals-Las Vegas

05/195-11/1997

Process incoming calls from physicians wanting Prior Authorization number in order to do procedure

Input all authorizations applications into system

Process hospital admissions to give a Prior Authorization/ process UR Nurse Notes

Process all new applications to be a provider for NPP and send out all letters for verification

Setup board meetings and setup all new physician folders for board to process

Education

Grover Cleveland High School-Reseda Californai

Memberships

NAAMS

References on Request



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