Address
Form of work
SalaryJob Detail
Job Title:
Credentialing Specialist - DH Physician Billing - Full-Time - DaysReq:
2024-0020Location:
Swamp RoadDepartment:
DH Physician BillingSchedule:
Job Description:
- PURPOSE OF JOB:
The Credentialing Specialist is responsible for ensuring the continuity of provider participation with managed care organizations and all other payers by managing the credentialing process and timely submission of required documents. Monitors provider and managed care organization reporting and maintains provider credentialing. Acts as primary credentialing and privileging resource for organization, ensuring that eligible staff members obtain and maintain current clinical credentials with payers and, as applicable, clinical and prescribing privileges, license/certification renewal, and maintaining information/filing systems on credentialing and privileging processes.
- ESSENTIAL FUNCTIONS
- Credentialing implementation
- Provider Licensure
- Data Base Management
- Organizational Communication
- Other duties as assigned and requested.
Job Qualifications:
QUALIFICATIONS:
- Education: High School diploma, college degree preferred with additional business/medical secretarial training preferred
- Experience: At least 2 years of payer credentialing experience.
- Other Skills:
- Knowledge of Microsoft Office Applications
- Organizational and problem solving skills
- Data entry/database management
