Medical Staff Credentialing Manager jobs in Allentown, PA

Summary: Performs specialized duties in the administration of credential requirements and procedures. Position will be part-time with flexible hours.

Essential Duties and Responsibilities include the following:

• Register and record credentials for providers and assist in making application for credentials for hospital and insurance carriers both on paper and through electronic formats; notify of credential expiration date and assist in applying for credential renewal.
• Counsel providers concerning coursework, which might be taken to meet credential requirements; review transcripts submitted in connection with credential applications and provide advice on possible eligibility for credentials.
• Assist applicants in preparing forms required for official evaluation of transcripts.
• Review assignment authorizations and payroll listings of certificated personnel to verify that proper credential is held for current assignment.
• Audit schedules to ensure appropriate assignment; research and resolve credential authorization problems.
• Maintain records of certified personnel assignments to ensure proper authorization. Update electronic billing system with provider’s numbers and trouble shoot credentialing issues for business office.
• Verify employment experience for the issuing or renewal of credentials.
• Prepare forms to input credential data to employee database; post credential information to employee history file; gather data for and type forms, letters and reports; maintain records and files.
• Perform administrative assistant functions for the CFO.
• Other duties may be assigned.

Computer experience essential

Excellent organization skills

Electronic practice management documentation experience preferred

Excellent verbal and written communication skills

Other Qualifications

Knowledge of insurance carrier requirements

Attention to detail

Prior experience with hospital and insurance credentialing including CAQH, NPI and PECOS

Must be available to work flexible hours