Medical Staff Credentialing Specialist, Sr. processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist, Sr. 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, Sr. handles and resolves inquiries regarding credentialing information, process, or status. May provide guidance or expertise to less experienced specialists. Requires a high school diploma. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor. The Medical Staff Credentialing Specialist, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Medical Staff Credentialing Specialist, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Open Door Family Medical Center provides health care and wellness programs to individuals and families in need throughout Westchester, Putnam and Ulster Counties.
A pioneer Federally Qualified Health Center, Open Door provides more than 300,000 patient visits annually and serves nearly 60,000 individual patients who might not otherwise have access.
Open Door offers integrated services and a holistic approach to building healthier communities. Primary medical care, dental care, integrated behavioral health care, clinical nutrition, wellness programs, and chronic disease management are the foundation of its clinical programs.
Open Door is seeking a Billing & Credentialing Specialist located out of our Ossining, NY headquarters. The aim of the New York State Department of Health (NYSDOH) Cancer Services Program (CSP) is to improve access to, and utilization of, high quality, guideline-concordant breast, cervical and colorectal cancer screening services for residents of New York State (NYS).
Responsibilities of the Billing & Credentialing Specialist include managing the Direct Provider Payment process and the contracted provider credentialing process.
Responsibilities
BILLING DUTIES
tracks identified issues from start to finish
CREDENTIALING DUTIES
GENERAL DUTIES
COMMUNICATION
PLANNING
Attends staff and other organizational meetings, as designated, to ascertain and contribute to short- and long-range plans, programs, and goals within areas of responsibility
Participates in staff development programs, educational activities, seminars, and training opportunities
COMPLIANCE MANAGEMENT
Maintains client confidentiality at all times per the Health Insurance Portability and Accountability Act (HIPAA)
Prepares and maintains documentation in compliance with policies and procedures and applicable city, state, and federal laws
Meets annual mandatory training requirements
Qualifications
EDUCATION
Bachelors degree required
EXPERIENCE
SKILLS
ADDITIONAL REQUIREMENTS
Must have a driver’s license valid in New York State and occasional / as needed access to car
There are many fantastic benefits to a career at Open Door Family Medical Centers. In addition to working to effect positive change in the health and lives of thousands of residents in our communities, Open Door offers its employees a stimulating, diverse and team-based work environment with comprehensive benefits including medical, dental, life insurance, flexible spending accounts, 401(k), generous paid time off, and educational assistance.
Aside from excellent benefits, we offer a competitive salary and annual bonuses based on organizational and individual objectives.
Open Door is an Equal Opportunity Employer
Last updated : 2024-04-25
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