Key Responsibilities:
Job Description:
- Responsible for all aspects of new and existing provider credentialing and re-credentialing including initial application for all providers.
- Complete credentialing applications to add providers to commercial payers, and Medicaid.
- Review credentialing application for completeness and log any missing documentation
- License Renewals: Ensures that physician licenses are renewed prior to expiration.
- Records Management: Maintains assigned physician files, updating each item/action as processed
- Ensure that information is current and accurate and ensure appropriate follow-up with Insurance carriers
- Knowledge and experience with CAQH, Availity, NPI type 1 and 2.
- Maintain confidential and sensitive information with discretion.
- Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
Required knowledge, skills and abilities:
- Knowledge of provider credentialing with a minimum of two years of previous experience preferred
- Excellent computer skills including Excel, Word, and Internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Communicates clearly and effectively
- Strong attention to detail and ability to manage multiple tasks simultaneously
- Excellent communication and interpersonal skills, with the ability to work collaboratively with staff and providers.
