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)
This position is one of the most important functions in the facility and usually the first point of contact with the patient either personally or by telephone. The position acts as the patient greeter, provides information to the patient and begins the registration process.
Essential Functions:
Ensures that all necessary demographic, billing, and clinical information is obtained and entered in the registration system with timeliness and accuracy.
Distributes and explains forms, documents, and educational handouts to patients or family members.
Verifies insurance benefits and obtains precertification/authorization as necessary. Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for follow up.
Schedule appointments per established policies and procedures.
Answer all incoming calls and route them appropriately.
Work closely with nurses and providers to assure smooth patient flow.
Follow up on "no show" patients on daily basis.
Education: High school diploma required.
Required Skills: Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
Experience: Prefer at least two (2) years' experience in a medical office setting.
Clear All
0 Medical Staff Credentialing Specialist jobs found in Kingsport, TN area