Credentialing Specialist

Orlando Family Physicians, LLC

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.

Job Summary

Assisting medical professionals by verifying licensing, their training, schooling. Making sure they meet the Federal and State and NCQA standards and requirements of their profession. Filing payor's applications, making the changes for licenses and certificates for the new providers files and assisting on the Updates of various web sites.

Responsibilities :

• Assist to change Medical Licenses and DEA Certificates of newly hired Providers.
• Assist Updating the CVs, gathering all the demographics for the Provider Information forms.
• Verifying licensure, certificates and training of medical providers.
• Gathering the components of a Credentialing Package for the new Providers. Initiating CAQH files ready for new providers National credentialing files.
• Assist on the constant updating of the CAQH and Healthgrades various other Web sites.
• Assist redacting Introduction letters and training for our new providers and their State and National guidelines.
• Processing payors applications for the newly hired providers, and the applications for renewals every two to three years for existing providers.
• Understanding of the different requirements of payors and the way these requirements change.
• Keeps the "timeline" for provider applications so we can manage a large group of constant pending files.
• Constant Audits of the work done to assure accuracy and quality.
• Keeping up with all application status to assure credentialing completeness.
• Constant communication with the team.
• Cooperation with all other company teams and their needs for credentialing information.
• Maintaining open communications with office administrators to ensure the exchange of renewed certificates and licensing.
• Assist in anything the Credentialing Specialist needs

Skills and Specifications