Medical Records Credentialing Specialist
Resume:
Tabitha Thompson
Deville, LA *****
*************@*****.***
PROFESSIONAL To seek and maintain full-time position that offers professional challenges SUMMARY utilizing interpersonal skills, excellent time management and problem-solving skills. Work Experience
Work History Billing/credentialing Specialist
Cloud Pediatrics - Pineville, LA
January 2020 to Present
Obtained NPI numbers for providers and facilities and updated existing profiles. Enrolled providers and Medicaid, Medicare and private insurance plans. Completed human resource operational requirements by scheduling and assigning employees. Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency.
Verified all patients insurance before being seen. Collected copays/balances.
Made sure all codes were correct before being sent to clearinghouse. Conducted primary source verifications such as background checks and board certifications. Adhered to strict HIPAA guidelines to protect patient privacy. Coordinated patient scheduling, check-in, check-out and payments for billing. Managed multi-line phone system and pleasantly greeted patients. Helped patients complete necessary medical forms and documentation. Checked patient insurance, demographic and health history to keep information current. Maintained current and accurate medical records for patients. Organized paperwork such as charts and reports for office and patient needs. Transcribed phone messages and relayed to appropriate personnel. Kept waiting room neat and organized by stacking magazines, removing trash and cleaning glass. Responded to correspondence from insurance companies to verify patient's coverage. Scheduled, rescheduled and cancelled appointments for dental patients. Received, recorded and filed medical payments by check, cash and credit card. Welcomed [Number] patients and visitors per day via telephone and in person. Filed and retrieved patient records for provider.
Entered procedure codes and diagnosis codes into medical billing software. Billing/credentialing Specialist
Mansoor Pediatrics - Alexandria, LA
April 2006 to January 2020
Conducted primary source verifications such as background checks and board certifications. Received and evaluated applications to look for missing and inaccurate information. Obtained NPI numbers for providers and facilities and updated existing profiles. Enrolled providers and Medicaid, Medicare and private insurance plans. Adhered to strict HIPAA guidelines to protect patient privacy. Coordinated patient scheduling, check-in, check-out and payments for billing. Managed multi-line phone system and pleasantly greeted patients. Helped patients complete necessary medical forms and documentation. Checked patient insurance, demographic and health history to keep information current. Maintained current and accurate medical records for patients. Organized paperwork such as charts and reports for office and patient needs. Transcribed phone messages and relayed to appropriate personnel. Kept waiting room neat and organized by stacking magazines, removing trash and cleaning glass. Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.
Enhanced office productivity by handling high volume of callers per day. Responded to correspondence from insurance companies to verify patient's coverage. Completed and filed financial documentation for accounting purposes. Used computer programs and registration systems to schedule patients for routine and complex procedures.
Completed clerical duties and tasks for clinic administration. Education
GED
Pineville High School - Pineville, LA
May 1998
Skills
• SKILLS Provider Enrollment Front Desk Operations Employment Recordkeeping Insurance Claims
Community Health Center HIPAA Guidelines
Credentialing Patient Billing
Credentialing Requirements Patient Eligibility Requirements Credential Verification
Facility Credentialing
• Medical Billing
• Insurance Verification
• Medical Scheduling
• Medical Records
• ICD-10
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