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)
Description
The Credentialing Specialist is responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing process for established providers and new providers joining the medical group. The Credentialing Specialist must be able to work independently with minimal oversite, think outside the box, and work in a fast paced, high volume work environment. The Credentialing Specialist must also be able to multitask and prioritize in order to execute in a timely manner, be detail oriented, have strong communication skills, and always want to learn more.
Responsibilities:
· Collect credentialing and re-credentialing materials for providers.
· Submit enrollments for providers with various payors.
· Follow up on enrollment statuses with payors.
· Maintain credentialing database & CAQH.
· Renew expirables, such as licenses & certifications.
· Submit notifications for offboarding providers and location changes.
· Monitor & maintain credentialing email.
· Manage Payor Portal emails and access.
· Additional duties assigned by the supervisor.
Requirements
Compensation Package
At BASS Medical Group, we understand that a comprehensive, high quality, and affordable health benefits program is now more essential than ever. The overall well-being of our employees is at the forefront of our focus. With this in mind, we offer our eligible employees a generous benefits program.
Health & Welfare Benefits: Medical through Anthem Blue Cross PPO, Low-Cost Dental and Vision, Medical FSA & HSA.
Retirement Savings & Income Security: Basic Life & AD&D Insurance, Long Term Disability, 401K plan with an employer contribution, Access to Financial Advisors, Identity Theft Program.
Work/Life Balance Benefits: Paid Time Off and Company Paid holidays, Life Assistance Program, Commuter & Parking Benefits, Secure Travel Services, Healthy Rewards Program, Will Preparation Program, Additional perks to include discounts for Cellular phone and Gym memberships.
Voluntary Benefits: Optional Life & AD&D Insurance, Aflac Supplemental Insurance, Pet Insurance
Compensation will be based on experience
Pay Scale/Ranges:
$25.00-$30.00/hour (and the hourly equivalent for salaried employees).*
*Employees actual pay rate will depend on a host of factors including, without limitation, job location, specialty, skillset, education, and experience. The patey scale/ranges shown are representative of the pay rates for the job title reflected above, but an employees actual pay rate will be determined on a case-by-case basis.
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