Medical Staff Credentialing Specialist

4 weeks ago


Annapolis, Maryland, United States Vision Innovation Partners Support Center Full time
Job Title: Credentialing Specialist

Overview:

The Credentialing Specialist will be responsible for processing payer enrollment and credentialing for all medical staff providers with insurance payers. This role will also assist with processing medical staff credentialing and privileging medical staff providers as needed and/or directed. This role will have an emphasis on knowledge and experience with Vision Payers.

Responsibilities:
  • Interface effectively with VIP leaders, providers, office managers, and other stakeholders to ensure timely completion of all provider applications.
  • Work efficiently and supportively with a team.
  • Assist with the routing process as needed.
  • Maintain up-to-date physician database systems (CAQH, PECOs, 3won) maintenance and accuracy.
  • Assist the department manager with projects as assigned and perform other duties when necessary in conjunction with the department manager.
  • Other job duties as assigned.
Qualifications:
  • High School Diploma or equivalent.
  • Preferred: BA/BS degree in business or related field.
  • A part of your roles and responsibilities are holding yourself to a higher standard and being a role model for corporate compliance and ethical behavior. You have a responsibility to report suspected wrongful conduct and/or violations of policies and procedures in good faith as soon as you become aware of them.
  • As a part of your role in the organization, you have access to patient health information through either the electronic health record or the practice management system. It is your responsibility to use only the minimum information necessary to complete the task assigned to you.


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