Credentialing Specialist

Woundlocal • Austin, TX

19d

About The Position

Under general supervision, the credentialing specialist is responsible for assuring the proper credentialing and privileging of physicians and mid-level providers. This position is responsible for the initial credentialing, recredentialing and ongoing monitoring of sanctions and exclusions process for practitioners. This position is also responsible for meeting daily/weekly production goals and maintaining high level of confidentiality for provider information.

Requirements

• Three (3) years administrative experience, preferably in the hospital or clinical field, is required.
• Ability to effectively serve the customer’s need strong attention to detail and ensuring accuracy.
• Ability to work independently under limited supervision
• Strong multitasking and organizational skills
• Exhibits accuracy and thoroughness; monitors own work for quality
• Strong organizational and time management skills
• Proficiency in relevant software such as HSTREAM, PECOS, Availity, Cigna, UHC, and other payer portals.
• Strong verbal, written, and interpersonal communication skills

Responsibilities

• Guide provider through credentialing and re-credentialing process and ensure the completion of required documentation for IndieMD TX
• Works with provider to prepare and submit Medicare & Medicaid applications to enrollment office.
• Prepare all credentialing applications, develop, and provided documentation that are not supplied by the provider, address any additional information or corrections requested.
• Verify and track the proper credentialing and re-credentialing of Physicians and mid-level providers within IndieMD TX.
• Receive credentialing application and enter data into credentialing system
• Work with Provider to maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications for each provider, generate monthly report of expiring credentials.
• Ensure ongoing monitoring of performance between credentialing cycles, generate performance review documentation, share with department for completion, and notify external entities when a provider has been suspended, if necessary.
• Notify providers and departments of credentialing status and result, email notice to department and provider, ensure credentialing system is updated with final credentialing result.
• Track and ensure the completion of required continuing medical education courses/workshops; provide documentation to outside entities according to requirements.
• Perform all other duties as assigned.

Benefits

• Great team! We spend a ton of time hiring and training the best people.
• Great pay! We pay very well.
• Great opportunities! We're growing and we like to promote from within. If you're a true rock star, the opportunities are limitless!

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed