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credentialing specialist: Resume Samples & Writing Guide

Irving Franklin 170 Woodland Drive, Fowler, CA 93625
irvingfranklin96@aol.com
711-837-4668

Employment history

Senior Credentialing Specialist, Microsoft Redmond, Washington
December 2015 – Present
  • Participate in regular meetings with providers and payers
  • Verify licensure, education, and training of providers
  • Perform other duties as assigned
Credentialing Specialist, Google Mountain View, California
July 2014 – November 2015
  • Process credentialing applications and maintain up-to-date credentialing records
  • Perform other duties as assigned
  • Manage the data entry of credentialing information
Entry Level Credentialing Specialist, Walmart Bentonville, Arkansas
January 2013 – June 2014
  • Assist in the development and implementation of credentialing policies and procedures
  • Maintain accurate and complete provider files
  • Verify licensure, education, and training of providers

Education

University of Illinois, Urbana, Illinois
Bachelor of Science in Medical Office Administration, November, 2012

Skills

Database Management
Research
Risk Management
Presentation
Scheduling
Records Management
Word Processing
Typing

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Ursula Martin 560 Oakwood Road, Luther, IA 50152
martinursula4@mail.com
801-077-8790

Professional Summary

 Highly organized and detail-oriented professional with extensive experience in credentialing and administrative support. Proven track record of successfully managing a wide range of administrative tasks and ensuring timely completion of projects. 

Employment history

Chief Credentialing Specialist, Bank of America Charlotte, North Carolina
December 2009 – Present
  • Prepare and submit credentialing applications to payers
  • Verify licensure, education, and training of providers
  • Manage the data entry of credentialing information
Credentialing Specialist, Amazon Seattle, Washington
December 2008 – November 2009
  • Maintain a working knowledge of credentialing and payer requirements
  • Verify licensure, education, and training of providers
  • Perform other duties as assigned
Entry Level Credentialing Specialist, Apple Cupertino, California
May 2008 – November 2008
  • Manage the data entry of credentialing information
  • Maintain a working knowledge of credentialing and payer requirements
  • Prepare and submit credentialing applications to payers

Education

Cornell University, Ithaca, New York
MD in Business Administration, March, 2008
Cornell University, Ithaca, New York
Bachelor of Science in Medical Office Administration, March, 2004

Skills

Computer Literacy
Written Communication
Innovation
Accounting
Microsoft Office
Administrative Support
Typing
Verbal Communication
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Charles Adams 1 Sycamore St., Olton, TX 79064
charlesadams63@icloud.com
621-032-0395

Professional Summary

 Highly organized and detail-oriented Credentialing Specialist with extensive experience in administrative and clerical roles. Proven ability to manage complex projects and maintain accurate records while meeting tight deadlines. 

Employment history

Lead Credentialing Specialist, CVS Health Woonsocket, Rhode Island
January 2014 – Present
  • Participate in regular meetings with providers and payers
  • Identify and resolve credentialing discrepancies
  • Maintain accurate and complete provider files
Credentialing Specialist, Microsoft Redmond, Washington
January 2013 – December 2013
  • Manage the data entry of credentialing information
  • Participate in regular meetings with providers and payers
  • Respond to inquiries from providers and payers
Jr. Credentialing Specialist, Amazon Seattle, Washington
July 2012 – December 2012
  • Perform other duties as assigned
  • Assist in the development and implementation of credentialing policies and procedures
  • Identify and resolve credentialing discrepancies

Education

University of Illinois, Urbana, Illinois
Master of Arts in Human Resources Management, May, 2012
University of Illinois, Urbana, Illinois
Bachelor of Arts in Business Administration, May, 2008

Skills

Process Improvement
Interpersonal
Documentation
Computer Literacy
Filing
Administrative Support
Inventory Management
Spreadsheets
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Umberto Bailey 234 Hillside Drive, Eau Claire, PA 16030
bailey_umberto@zoho.com
957-997-4156

Employment history

Lead Credentialing Specialist, Bank of America Charlotte, North Carolina
August 2016 – Present
  • Monitor and track credentialing status for providers
  • Maintain a working knowledge of credentialing and payer requirements
  • Prepare and submit reports to management
Associate Credentialing Specialist, Walmart Bentonville, Arkansas
March 2015 – July 2016
  • Monitor and track credentialing status for providers
  • Respond to inquiries from providers and payers
  • Perform other duties as assigned
Jr. Credentialing Specialist, Google Mountain View, California
August 2014 – February 2015
  • Coordinate and facilitate the re-credentialing process
  • Prepare and submit credentialing applications to payers
  • Perform other duties as assigned

Education

University of Wisconsin, Madison, Wisconsin
Master of Arts in Business Administration, July, 2014
University of Wisconsin, Madison, Wisconsin
Bachelor of Arts in Accounting, July, 2010

Skills

Mentoring
Negotiation
Process Improvement
Troubleshooting
Medical Terminology
Word Processing
Quality Control
Verbal Communication
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Marcus Clark 245 Millwood Drive, Cañoncito, NM 87505
clark_marcus@hotmail.com
755-142-2071

Professional Summary

 Highly organized and detail-oriented Credentialing Specialist with extensive experience in the administrative and clerical field. Skilled in managing data and streamlining processes to ensure efficient and accurate credentialing. 

Employment history

Lead Credentialing Specialist, JPMorgan Chase New York, New York
October 2014 – Present
  • Maintain accurate and complete provider files
  • Perform other duties as assigned
  • Manage the data entry of credentialing information
Associate Credentialing Specialist, UnitedHealth Group Minnetonka, Minnesota
October 2013 – September 2014
  • Identify and resolve credentialing discrepancies
  • Process credentialing applications and maintain up-to-date credentialing records
  • Manage the data entry of credentialing information
Junior Credentialing Specialist, JPMorgan Chase New York, New York
May 2012 – September 2013
  • Monitor and track credentialing status for providers
  • Prepare and submit reports to management
  • Participate in regular meetings with providers and payers

Education

Cornell University, Ithaca, New York
Medical Office Administration, March, 2012

Skills

Flexibility
Research
Strategic Thinking
Supervisory
Office Administration
Data Collection
Documentation
Scanning
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credentialing specialist Job Descriptions; Explained

If you're applying for an credentialing specialist position, it's important to tailor your resume to the specific job requirements in order to differentiate yourself from other candidates. Including accurate and relevant information that directly aligns with the job description can greatly increase your chances of securing an interview with potential employers.

When crafting your resume, be sure to use action verbs and a clear, concise format to highlight your relevant skills and experience. Remember, the job description is your first opportunity to make an impression on recruiters, so pay close attention to the details and make sure you're presenting yourself in the best possible light.

1

credentialing specialist

  • Display in-depth knowledge of and execute all standard operating procedures (SOPs) as well as communicating issues, trends and concerns to Senior Credentialing Specialist and Credentialing Manager 
  •  Assisting with supporting credentialing program which includes ensuring the quality of credentialing of contracted providers in accordance with NCQA and URAQ guidelines 
  • Handle multiple states for initial and re-credentialing applications
  • Manage files to continuously meet department goals while meeting daily production 
  • Assist with different projects (Partner Health Plan; World Trade Center; Ancillary ;PPO)
2

credentialing specialist

  • Filling out insurance applications
  • Making multiple calls a day to insurance companies to check the status of the providers applications
  • Sending biweekly updates to the providers on their application status
  • Used excel daily for documentation
3

credentialing specialist

  • Submitting Medicaid recertification statements for different providers and departments
  • Developed a credentialing database that is user-friendly and informative for reporting purposes 
  • Created a  native desktop application that completed about 1,900 claims every 8 hours.
  • Automated financial reporting using VBA.
  • Provided technical support to fellow colleagues.
4

credentialing specialist

  •  Handle multiple states for initial and re-credentialing applications 
  •  Retrieving documents received via RightFax 
  •  Assisted in mailing monthly term letters to providers 
  •  Reviews and screens initial medical staff credentialing applications for completeness, accuracy, and compliance with all guidelines, policies, and standards 
  • Performs external research and conducts verification of all applicant licensure, education and training, relevant past employment, and affiliations; assesses compliance with risk exposure criteria 
  • Meeting the turn around time for multiple states 
  •  Performs internet, agency, and/or internal research as appropriate to assess past high risk/liability activity with respect to medical staff; analyzes and prepares finding and submits to management 
5

credentialing specialist

  • Provides a range of fiscal planning, administrative, and/or office managerial support to the CVO, as appropriate to the position. 

credentialing specialist Job Skills

For an credentialing specialist position, your job skills are a key factor in demonstrating your value to the company and showing recruiters that you're the ight fit for the role. It's important to be specific when highlighting your skills and ensure that they are directly aligned with the job requirements, as this can greatly improve your chances of being hired. By showcasing your relevant skills and experience, you can make a compelling case for why you're the best candidate for the job.

How to include technical skills in your resume:

Technical skills are a set of specialized abilities and knowledge required to perform a particular job effectively. Some examples of technical skills are data analysis, project management, software proficiency, and programming languages, to name a few.

Add the technical skills that will get hired in your career field with our simple-to-use resume builder. Select your desired resume template, once you reach the skills section of the builder, manually write in the skill or simply click on "Add more skills". This will automatically generate the best skills for your career field, choose your skill level, and hit "Save & Next."

  • Data Entry
  • Microsoft Office
  • Typing
  • Data Analysis
  • Office Administration
  • Filing
  • Scanning
  • Records Management
  • Scheduling
  • Spreadsheets
  • Word Processing
  • Medical Coding
  • Medical Terminology
  • Customer Service
  • Data Collection
  • Documentation
  • Verbal Communication
  • Computer Proficiency
  • Quality Control
  • Inventory Management
  • Administrative Support

How to include soft skills in your resume:

Soft skills are non-technical skills that relate to how you work and that can be used in any job. Including soft skills such as time management, creative thinking, teamwork, and conflict resolution demonstrate your problem-solving abilities and show that you navigate challenges and changes in the workplace efficiently.

Add competitive soft skills to make your resume stand-out to recruiters! Simply select your preferred resume template in the skills section, enter the skills manually or use the "Add more skills" option. Our resume builder will generate the most relevant soft skills for your career path. Choose your proficiency level for each skill, and then click "Save & Next" to proceed to the next section.

  • Communication
  • Interpersonal
  • Leadership
  • Time Management
  • Problem Solving
  • Decision Making
  • Critical Thinking
  • Creativity
  • Adaptability
  • Teamwork
  • Organization
  • Planning
  • Public Speaking
  • Negotiation
  • Conflict Resolution
  • Research
  • Analytical
  • Attention to Detail
  • Self-Motivation
  • Stress Management
  • Collaboration
  • Coaching
  • Mentoring
  • Listening
  • Networking
  • Strategic Thinking
  • Negotiation
  • Emotional Intelligence
  • Adaptability
  • Flexibility
  • Reliability
  • Professionalism
  • Computer Literacy
  • Technical
  • Data Analysis
  • Project Management
  • Customer Service
  • Presentation
  • Written Communication
  • Social Media
  • Troubleshooting
  • Quality Assurance
  • Collaboration
  • Supervisory
  • Risk Management
  • Database Management
  • Training
  • Innovation
  • Documentation
  • Accounting
  • Financial Management
  • Visualization
  • Reporting
  • Business Acumen
  • Process Improvement
  • Documentation
  • Relationship Management.

How to Improve Your credentialing specialist Resume

Navigating resume pitfalls can mean the difference between landing an interview or not. Missing job descriptions or unexplained work history gaps can cause recruiters to hesitate. Let's not even talk about the impact of bad grammar, and forgetting your contact info could leave your potential employer hanging. Aim to be comprehensive, concise, and accurate.

Mark Foster 831 Parkwood Drive, Cardwell, MT 59721

Employment history

Lead Credentialing Specialist, Google Mountain View, California
November 2018 – May 2022
  • Verify licensure, education, and training of providers
  • Maintain a working knowledge of credentialing and payer requirements
  • Manage the data entry of credentialing information
Associate Credentialing Specialist, UnitedHealth Group Minnetonka, Minnesota
May 2017 – October 2018
  • Manage the data entry of credentialing information
  • Maintain a working knowledge of credentialing and payer requirements
  • Ensure compliance with all applicable laws and regulations
Junior Credentialing Specialist, General Electric Boston, Massachusetts
November 2016 – April 2017
  • Maintain a working knowledge of credentialing and payer requirements
  • Monitor and track credentialing status for providers
  • Coordinate and facilitate the re-credentialing process

Education

University of Wisconsin, Madison, Wisconsin
Bachelor of Arts in Business Administration, September, 2016

Skills

Customer Service
Emotional Intelligence
Organization
Negotiation
Computer Proficiency
Administrative Support
Customer Service
Verbal Communication

Provide your Contact Information and Address Year Gaps

Always explain any gaps in your work history to your advantage.

Key Insights
  • Employers want to know what you've accomplished, so make sure to explain any gaps using a professional summary.
  • Adding extra details and context to explain why you have a gap in your work history shows employers you are a good fit for the position.

How to Optimize Your credentialing specialist Resume

Keep an eye out for these resume traps. Neglecting to detail your job roles or explain gaps in your career can lead to unnecessary doubts. Grammar blunders can reflect negatively on you, and without contact information, how can employers reach you? Be meticulous and complete.

Francis King 524 Hillcrest Drive, McKees Rocks, PA 15136
francisking18@aol.com
798-657-1661

Professional Summary

 Highly organized and detail-oriented Credentialing Specialist with extensive experience in administrative and clerical roles. Skilled in data entry, filing, record keeping, and customer service. 

Employment history

Lead Credentialing Specialist, Apple Cupertino, California
April 2014 – Present
  • Maintain a working knowledge of credentialing and payer requirments
  • Monitor and track credentialing statu for providers
  • Prepare and submitt report to managment
Credentialing Specialist, JPMorgan Chase New York, New York
November 2012 – March 2014
  • Prepare and submit credentialing aplications too payers
  • Assist in the developement and implemention of credentialing policies and procedures
  • Respond too inquirys from providers and payers
Jr. Credentialing Specialist, Microsoft Redmond, Washington
November 2011 – October 2012
  • "I am going to the store to buy some food
  • I am going to the store too buy some food.

Education

Harvard University, Cambridge, Massachusetts
Accounting, September, 2011

Skills

Decision Making
Reliability
Analytical
Conflict Resolution
Data Collection
Computer Proficiency
Documentation
Word Processing

Include Job Descriptions and Avoid Bad Grammar

Avoid sending a wrong first impression by proofreading your resume.

Key Insights
  • Spelling and typos are the most common mistakes recruiters see in resumes and by simply avoiding them you can move ahead on the hiring process.
  • Before submitting your resume, double check to avoid typos.

credentialing specialist Cover Letter Example

A cover letter can be a valuable addition to your job application when applying for an credentialing specialist position. Cover letters provide a concise summary of your qualifications, skills, and experience, also it also gives you an opportunity to explain why you're the best fit for the job. Crafting a cover letter that showcases your relevant experience and enthusiasm for the Accounts Payable role can significantly improve your chances of securing an interview.



Irving
Franklin irvingfranklin96@aol.com
711-837-4668
170 Woodland Drive, Fowler, CA
93625

Senior Credentialing Specialist
UnitedHealth Group
Minnetonka, Minnesota

Greetings UnitedHealth Group Recruitment Team


I am excited to apply for the Senior Credentialing Specialist role at UnitedHealth Group. As a highly skilled Credentialing Specialist, I am confident that I have the necessary experience and abilities to make a valuable contribution to your organization.


Throughout my life, I have pursued my passion for Project Management and sought out opportunities to learn and grow. My experience in Administrative & Clerical has given me valuable skills such as Database Management and Research that have allowed me to improve professionally and personally. I am excited to bring these skills and my passion as a Credentialing Specialist to the position and work with a team of like-minded individuals to achieve our common goals.


Thank you for considering my application for the Senior Credentialing Specialist role. I am looking forward to a future where we work together to drive this organization's success.


Best regards,
Irving Franklin
711-837-4668
irvingfranklin96@aol.com

Irving Franklin






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