Credentialing Administrative Assistant - Hybrid

IVI America•Basking Ridge, NJ

10h•$20 - $22•Hybrid

About The Position

We are looking to hire an organized credentialing administrator to assist us with administrative tasks pertaining to our practitioners' insurance credentialing. The credentialing coordinator will organize, maintain, and verify all aspects of the process, and maintain current files on practitioners. To be successful in this role you should ensure the currency and accuracy of all information.

Requirements

High school diploma, GED, or suitable equivalent.
Extremely detail oriented and able to prioritize tasks accordingly.
Excellent verbal and written communication skills.

Nice To Haves

1 year of credentialing experience with medical staff.
Knowledge of medical credentialing and privileging procedures and standards.

Responsibilities

Create CAQH profiles for all new providers in our US clinics.
Identify discrepancies or missing information and conduct follow-ups.
Update and re-attest each provider profile quarterly and/or as needed.
Complete and submit initial applications to commercial insurances for participation.
Notify health plans of provider information/demographical updates and changes as well as practitioner status changes.
Update demographic information and provide supporting documents to outside stakeholders, such as commercial managed care plans.
Ensure re-credentialing is completed timely to prevent any lapse in enrollment.
Respond to health plan provider inquiries.
Work closely with the billing staff to identify and resolve any denials or authorization issues related to provider credentialing.
Maintain individual provider files to include up to date information needed to complete commercial payer credentialing and recredentialing.
Maintain knowledge of current health plan and agency requirements for credentialing providers.