Medical Credentialing Specialist

Overview

Looking for full-time work (8 hours/day)

at $3.64/hour ($640.64/month)

Bachelors degree

Last Active

November 23rd, 2024 (3 days ago)

Member Since

July 5th, 2022

Profile Description

Meet Upgrade to see actual info, a seasoned Medical Assistant with expertise in medical credentialing, insurance onboarding, and administrative support.

She is skilled in verifying healthcare provider credentials, managing regulatory compliance, and maintaining thorough databases. She also knows how to use CAQH, Availity, GoHighLevel, and Excel to optimize operations and increase productivity.

Key Skills and Responsibilities:

> Credentialing and Re-credentialing: Manage provider credentialing for health plans to ensure state and federal requirements compliance. Maintain accurate databases, track documents, and manage re-credentialing papers.

> Compliance: Ensure compliance with regulatory and payer standards, assist providers with forms, and stay current on industry regulations.

> Communication: Work with providers, payers, and internal teams to offer updates, address difficulties, and organize credentialing operations.

> Data Management: Keep correct data, track license renewals, and provide reports on credentialing statuses.

> Process improvement and quality assurance involve implementing best practices, identifying process improvements, and conducting audits to assure accuracy.

>Medical scribing is the accurate documentation of patient contacts and supporting healthcare providers in keeping their medical records current.

> EHR (Electronic Health Records): Skilled in managing and updating patient data in electronic health systems to provide accurate and efficient healthcare delivery.

> EMR (Electronic Medical Records): Can process patient records electronically, assisting healthcare teams in tracking patient histories and treatments.

> Interprofessional Education (IPE): I have worked with various healthcare professionals to improve patient care via teamwork and communication.

> TikTok Policy Compliance: Expertise in analyzing producers' work for TikTok policy adherence, ensuring the content is consistent with platform requirements.

> Affiliate Marketing: Understanding affiliate programs, including outreach and contact with affiliates to promote content production and participation.

> Data Tracking and Reporting: The ability to keep orderly records (e.g., tracking sheets), analyze metrics, and provide progress reports for ongoing projects and campaigns.

> Communication & Coordination: Excellent communication skills, particularly in managing cross-functional tasks and collaborating with multiple teams to achieve goals. TikTok Policy Compliance: Expertise in reviewing creators' content for TikTok policy adherence, ensuring it aligns with platform guidelines.


Software expertise:
1. GoHighLevel 
2. Availity
3. Excel
4. Zoom
5. Ringotel
6. Five9
7. Google Workspace
8. Notion
9. Asana

Upgrade to see actual info has a sharp eye for detail and excels in the following areas:
Medical Credentialing
CAQH Management
Verification of License and Renewal-PECOS and HIPAA Compliance
Administrative and Office Management
Technical and Customer Support
Appointment Setting (Outbound and Inbound Calls)
Bookkeeping and Data Entry
Social Media Management and Digital Marketing

With her dedication to providing high-quality services, Upgrade to see actual info turns obstacles into opportunities for achievement. 

Allow her to help you achieve your credentialing and administrative management objectives. 

Let's work together!