Credentialing Specialist- CH Medical Staff Services- FT / Days

Job Description

The Credentialing Specialist is responsible for the development, maintenance, and reporting for credentialing work as it relates to payer and facility credentialing. The specialist is responsible for direct maintenance of provider files for payer credentialing as well as maintaining credentialing software and billing systems appropriately.

Responsibilities

Creation of initial credentialing file for providers and facilities

Submission of provider and facility paperwork / forms based on payer requirements

Communicates with providers and service lines to obtain necessary data for submission to payers

Responsible for re-certification in a timely manner for provider and facility contracts

Documents receipt of all correspondence appropriately

Updates and / or corrects provider and facility information as needed

Compile reports on inflow and outflow of credentialing tasks

May perform other duties as assigned or requested and job specification can be modified or updated at any time

Qualifications

Required Education : High School Diploma / GED

Required Experience : At least one (1) year of experience in a physician office or medical billing operation. Strong PC skills, including word processing and spreadsheets. Must have the ability to learn and utilize custom systems and applications. Results-oriented mindset coupled with the ability to work both collaboratively and autonomously.