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1. Maximizing Your Resume's Impact with Credentials
Your resume is your ticket to securing interviews and ultimately landing your dream job. In today's
competitive job market, it's crucial to ensure that your resume stands out from the crowd. One
effective way to do this is by including relevant credentials that demonstrate your qualifications and
expertise in your field.
Credentials on a resume refer to any certifications, licenses, degrees, or professional designations that
you have earned throughout your career. These credentials not only validate your skills and
knowledge but also serve as proof to potential employers that you are a qualified candidate for the
position.
When including credentials on your resume, it's essential to strategically place them in a prominent
location where hiring managers can easily spot them. Typically, credentials are listed either after your
name at the top of the resume or in a separate section dedicated to certifications and qualifications.
The types of credentials you include will depend on your industry and the specific requirements of
the job you're applying for. For example, if you're in the healthcare field, relevant credentials might
include CPR certification, nursing licenses, or board certifications in a specialty area. In the tech
industry, credentials could include IT certifications such as CompTIA A+ or Cisco CCNA.
Here are some tips for effectively incorporating credentials into your resume:
1. Prioritize Credentials: Highlight the most relevant and impressive credentials that directly
relate to the job you're applying for.
2. Use Proper Formatting: Make sure credentials are listed clearly and consistently, using the
appropriate formatting (e.g., abbreviations, acronyms) to ensure readability.
3. Include Expiration Dates: If applicable, include expiration dates for certifications to indicate
that they are current and up to date.
4. Provide Context: Briefly explain the significance of each credential and how it demonstrates
your qualifications for the position.
5. Be Honest: Only include credentials that you have legitimately earned, and be prepared to
provide proof if requested during the hiring process.
In summary, incorporating credentials into your resume can significantly enhance your chances of
impressing potential employers and securing job interviews. By showcasing your qualifications and
expertise upfront, you can make a strong first impression and position yourself as a top candidate for
the position. So don't forget to highlight your credentials on your resume and let your qualifications
speak for themselves.
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creating tailored resumes that showcase your unique skills and qualifications, helping you land the
job you deserve.

2. Beginning knowledge of Human Resources issues related to confidentiality, EEOC, ADA and other
related personnel issues preferred. Experience in the Information Technology industry for over 28
years. Completed credentialing for employment as well as with all insurance companies and
commercial payers in 19 states. Demonstrated ability to meet regular time and attendance
requirements. Microsoft Word, Excel, and Outlook experience required. Leads, coordinates, and
monitors the review and analysis of practitioner applications and accompanying documents, ensuring
applicant eligibility. Gather and maintain provider credentials and documents within a secure
network location. Assists with managed care delegated credentialing audits and conducts internal file
audits. Excellent verbal and written communication skills to effectively interact with physicians and
allied health professionals, their office credentialing representatives, and hospital personnel. Perform
ongoing research to correct data so it does not create duplicate provider, locations, payees, and
participation. Professional office experience may come from a variety of areas, but health care
credentials experience is preferred. Experience with ANY of the following: CAQH, PECOS, internal
credentialing, NCQA Standards related to credentialing, or CMS Regulations related to
credentialing. Coordinates with delegates to ensure all necessary information regarding credentialing
and recredentialing is received and entered in a timely basis. College degree or equivalent work
experience preferred. Associate or Bachelor’s degree in a healthcare-associated field. Build strong,
trusting and professional relationships with Healthcare Administrators and Vendors nationwide.
Provides credentialing and privileging verifications. Coordinates the credentialing and
recredentialing process for assigned providers. Minimum of five years’ experience working in
healthcare with 3-5 years previous credentialing experience required. Provide support services and
act as back up to clerical staff when necessary. Extensive knowledge both in speaking and writing in
Spanish. Experience in Researching and Applying Government Regulatory Information. Ensure
appropriate preparation of the Credentialing Committee meeting, promoting effectiveness and
efficiency. Prepare and maintain reports of credentialing activities such as payer enrollment statuses,
provider credentials, and client demographic data. On a daily basis, process all delegated
practitioners under the terms and conditions of the entities' delegated agreement, including files
credentialed through a Certified Verification Organization (CVO). Monitor non-returned
verifications, produce and send out 2nd and 3rd verification requests when needed. Greets and
assists all physicians and ancillary staff with issues in a prompt, courteous and professional manner.
Identify, research and resolve credentialing issues. Proficient in Microsoft Office Products, Word,
Excel and Outlook.

3. Maintains communications with provider offices to promote relationships imperative to process.
Maintains current copy of all medical staff bylaws, rules and regulations and is knowledgeable of
hospital bylaws and rules and regulations relating to credentialing processes. Prepare and coordinate
the processing of credentialing and re-credentialing applications. Educates and informs faculty and
division personnel about credentialing policies and procedures. Responsible for verifications for
medical staff and allied health professionals initial appointments, provisional reviews,
reappointments and privilege delineation. Identifies issues that require additional investigation and
evaluation, validates discrepancies and ensures appropriate follow-up. Create and manage an
electronic faculty filing system. Excellent verbal and written communication skills are essential.
Medical billing knowledge and experience is preferred. The minimum level of education depicted on
most resumes includes an associate’s degree in health information management. Process provider and
medical staff applications and reappointment paperwork. Must be able to work in a fast paced
production environment. Recommend adverse action to the State Army Surgeon for providers in
non-compliance with regulation. Experience related to managed care Allied Health credentialing is
preferred. Verify provider and group information with insurance companies (e.g. address
maintenance, provider roster maintenance, contracted plan maintenance, etc.). Perform primary
source verification for initial and re-credentialing of assigned providers utilizing NCQA Standards
and other federal and state regulatory requirements. Initiate recredentialing process for providers due
for recredentialing. Updating Managed Care Monthly (MCM) Updates with provider’s effective
dates. Two Years Managerial experience to a team of nine associates. Sometimes act as a technical
resource to others in own function. Support PACC Director and MC Resource to design innovative
education presentations for home health agencies, potential network partners, current network
partners, and the healthcare community. Query database on whether or not EPMG has a copy of
documents needed or if a term date has been indicated. Chooses appropriate channels and times to
discuss complaints and concerns. Oversees Credentialing Committees and approval of clean files
between committee cycles. Initiated the onboarding process by sending out a welcome letter to the
new hires and meets the new associate in person during orientation to collect paperwork. Experience
in the use of most office equipment (i.e. copier, printer, fax, scanner). Auditing credential files before
presenting to the Credentialing Committee. Work closely with the QI and QM departments to ensure
compliance with NCQA, CMS, state, and other regulatory agencies. Strong organizational skills and
a high level of attention to detail. Work with other Acadia departments to ensure a smooth physician
onboarding process, including the following departments on the following and other tasks.

4. Self-motivated and successful in working in a fast paced environment. Provides excellent customer
service in accordance with EmCare’s customer service standards to all internal and external parties.
Develops and maintains effective lines of communication necessary for CCF's day to day
credentialing operations. Act as project leader and assists in the development of provider data
reporting, as requested. The layout demonstrates applicant’s name in biggest font with a thin
underlining that runs the width of the CV. Provides support for medical staff and Plan
Administration for Due Process Proceedings by attending hearings and appeals meetings and
recording proceedings. Skills: Microsoft Office, Various Billing Software. Proficiency in Microsoft
Office applications including Word, Power Point, Excel, and Outlook is a must. Monitor Work in
Progress (WIP) file, promptly addressing incoming files for processing. Certification as a Provider
Credentialing Specialist (CPCS) from the National Association of Medical Staff Services, preferred.
Attends and participates in all team related meetings. Experience with using various methods for the
assessment of training processes and systems. Will utilize relevant LexisNexis products and tools
(e.g. MBS, Accurint, etc.) and external verification tools (SOS, etc.) on daily basis. Intermediate
level of proficiency with MS Excel and Word. Responsible for the credentialing for the entire
Medical Staff. Assists with managed care delegated credentialing audits, conducts internal file
audits. Answered any questions from provider's offices and walking them through the credentialing
application process if necessary. Adheres to credentialing timeframes and deadlines dictated by
regulatory bodies so that provider files stay in compliance at all times. Experience in Provider Data
Management, Customer Services or Claims. Demonstrate working knowledge of medical
terminology; excellent oral and written communication skills; and the ability to communicate with
stressful callers maintaining calmness, assertiveness and diplomacy. Check CAQH for reapplication
six months prior to the re-credentialing date. Work with PSV Coordinator on establishing verification
resources including NPDB, HIPDB and Criminal Background checks. Provides accurate medical
staff databases to the facility as well as other facility specific reports upon request. Detail - oriented,
well - organized and have the ability to multi - task effectively. With appropriate training, accept
additional related duties, as needed. Able to categorize storage for improve performance and.
Experience in Researching and Applying Government Regulatory Information. Non-voting
Membership The board shall have the authority to establish and define non-voting categories of
membership. Meets or exceeds departmental timeframes and quality metrics on a consistent basis.
Provide information to the Departmental Billing Office about prospective appointments to the
medical staff.

5. Work with Department of Medicine credentialing, Massachusetts General Medical Office, non-
employee office, and Harvard Medical School faculty affairs to determine required paperwork for
credentialing, appointments, reappointments, and promotions and facilitate completion of paperwork
through correspondence with personnel. Analyst will work closely with Credentialing manager to
validate that OptumRx Network pharmacies meet and maintain the appropriate credentialing
requirements, as well as quality management standards to serve as a Pharmacy Provider for
OptumRx. Managed compliance in accordance with Joint Commission and Utilization. Detail -
oriented, well - organized and have the ability to multi - task effectively. Sets up and maintains
provider information in online medical credentialing databases and system. Ensures that all
credentialing and re-credentialing of Medical Staff and Allied Health Professionals (AHP)
applications are processed in compliance with Medical Staff Bylaws and Rules and Regulations.
Works independently, is self-directed and effectively in a team high paced environment. Support
assessment and evaluations of CDO credentialing capabilities to ensure national standards and
guidelines are met for delegated credentialing. Maintains efficient and comprehensive working
knowledge of the office software, including but not limited to, physician profile software. Attend
trainings and reference materials including content, work instructions, and tools. Update appropriate
outside Credentialing databases and websites as necessary to ensure information is current and
accurate. Address first level escalation issues by investigating and troubleshooting with internal and
external stakeholders in order to execute win-win solutions. Communicate effectively with NWP
and KFHP to obtain human resources and provider contract information as inputs to the
credentialing and assessment processes. Additionally, they must have the ability to problem solve to
logical conclusion and demonstrate initiative and responsibility. Coordinates appointment and
reappointment process for all CCF- professional staff and Allied Health Professionals. Prepare
credential, assessment, and quality paper and electronic files for chief of service, Committee peer
reviewer, and Committee meeting. Accuracy in assessment and documentation of credentials. Peer
reviews files for accuracy and adherence operating policies, procedures and agency regulations.
Experience working with Compliance workflows and processes. Experience:Three (3) years of
administrative technical clerical experience OR An equivalent. Review all incoming verifications,
ECFMG, NPDB, and AMA or AOA profile reports. Fully proficient in online credentialing
applications, such as CAQH, Pecos, NPDB, OIG, and AMA's profile service. Advances department
meeting minutes to the appropriate leadership committee. Maintains current copy of all medical staff
bylaws, rules and regulations and is knowledgeable of hospital bylaws and rules and regulations
relating to credentialing processes. Improve efficiencies and service provided while reducing costs. If
you work in Project management and have your PMP certification, you should list this credential.
Assist with the client site credentialing process including gathering and documenting facility
requirements and assisting healthcare professionals in obtaining necessary requirements to ensure
assignment start dates are met. This position involves attention to detail in processing credentialing
applications according to regulatory requirements. Ten years of medical staffing experience,
specifically in the areas of physician recruiting, marketing, credentialing, privileging and licensure.
Ensures that all providers are re-credentialed or terminated in a timely manner.

6. In the event of a direct conflict between the provisions of these Bylaws and the mandatory
provisions of the Texas Non-Profit Corporation Act the Texas Non-Profit Corporation Act will be
controlling. Good written and verbal communication skills required. Excellent organizational skills,
attention to detail, written and verbal communication skills. Database management skills including
querying, reporting, and document generation. Prepare files other documents, as requested, for
review in an accurate, consistent, professional, and organized manner. When returned follow up with
Medical Director, if needed, in obtaining signatures and forward to the state agency. Review
healthcare providers’ submitted requirements including licensure, certifications, screens and other
critical documents using AMIE system to determine HP document status versus requirements needed
for specific assignment in order to pursue outstanding requirements. Performs data entry and scans
accurately and efficiently according to established policies, procedures and guidelines. Applies
general guidelines in determining whether provider meets criteria and documents deficiencies.
Working knowledge of Medical Staff principles and operations specific to regulatory expectations
(TJC, NCQA, CMS, Title XXII etc). Maintains credentialing compliance with the accrediting and
regulatory agencies (i.e., Joint Commission) while developing and maintaining a working knowledge
of the regulations. Skills: Excel Sheets And Word 2013, Advanced MD Medical Software, Lytec
Software, Practice Point Manager 6.5, Medical Manager, Next Gen Medical Software. Detail -
oriented, well - organized and have the ability to multi - task effectively. Work closely with the QI
and QM departments to ensure compliance with NCQA, CMS, state, and other regulatory agencies.
Serve as department ECHO Super User; pull and analyze credentialing reports and establish and
adhere to guidelines for standard work. Audit system for accurate and up-to-date provider
information. Accelerated release of next generation server management components, for a g.
Preferred Other Certified provider credentialing specialist or directly related or equivalent work
experience. Develops and implements ways in which to improve and more efficiently accomplish
compliance per NCQA per the delegated plans. Communicate privilege problems with assigned
Medical Director, Recruiting and Scheduling staff, when issues arise. Must have the ability to
prioritize and have good listening, written and oral skills. College degree or equivalent work
experience preferred. Auditing credential files before presenting to the Credentialing Committee.
Experience with clerical and administrative procedure such as filing and record keeping. Bylaws are
usually not signed and are typically created by the board of directors during a meeting. Possess
excellent interpersonal communication skills with the ability to build successful customer
relationships. Inform the assigned Medical Director, Recruiting and Scheduling staff when privileges
and malpractice coverage are granted on a practitioner. Ongoing review of processes to improve
performance and meet customer needs. Demonstrate problem-solving, critical thinking, and
deductive reasoning skills. Prepare and maintain reports of credentialing activities such as payer
enrollment statuses, provider credentials, and client demographic data.