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Physician Credentialing Specialist Part-Time
3 months ago
Duties and Responsibilities
Credentialing:
- Review and process providers' initial credentialing packets and supporting documentation.
- Follows up with the provider to ensure all information is obtained before onboarding
- Completes and processes payer enrollment applications for Providers for Medicare and submits required information to our PHO for credentialing for the remaining insurance carriers.
- Completes timely follow-up on all applications.
- Maintains provider's profiles and NPIs, CAQH, and internal spreadsheets.
- Ensure that re-credentialing is complete and timely to prevent any lapse in enrollment.
- Monitor and maintain current documents (licenses, malpractice insurance).
- Please keep all provider's information confidential.
Qualifications
- 3+ years of experience in Healthcare Provider credentialing, contracting with all Payers, Medicare, Medicaid, and all commercial plans
- Must have experience credentialing groups and individual providers,
- Must have experience with Pecos, CAQH, and NPPES sites
