Medical Staff Credentialing Specialist processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist handles and resolves inquiries regarding credentialing information, process, or status. Requires a high school diploma. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor. The Medical Staff Credentialing Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Medical Staff Credentialing Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Complete provider credentialing and re-credentialing application with contracted insurance companies and other accrediting entities.
Ensure all credentialing applications and forms are completed accurately, thoroughly and timely.
Monitor the status of each provider’s credentialing and re-credentialing application and forms. Follow-up with credentialing entities to ensure provider credentialing is completed timely.
Communicate status of provider credentialing to applicable practices and Administration.
Set up and maintain provider and practice information in online credentialing databases.
Contact and follow-up with providers to ensure all pertinent information is received to process credentialing, re-credentialing and accreditation to ensure timely filing and renewals.
Maintain credentialing files and documentation.
Maintain knowledge of credentialing guidelines and office participation and non-participation with insurance companies
Post and reconcile all payments received for clinic billing.
Prepare month-end payment reconciliation reports for clinics billing.
REQUIRED
PREFERRED
Education:
High school education or GED required
Associate’s Degree or higher preferred
Experience:
Three years billing, credentialing, denial management, etc.Insurance Credentialing experience preferred
Degrees, Licensure, and/or Certification:
Knowledge, Skills, and Abilities:
Detail Oriented, Confidentiality, Customer Service Oriented.
Clear All
0 Medical Staff Credentialing Specialist jobs found in Fayetteville, AR area