Credentialing Coordinator

7 days ago


Indianapolis, Indiana, United States JWM Neurology Full time
Job Title: Credentialing Specialist

At JWM Neurology, we are seeking a highly organized and detail-oriented Credentialing Specialist to join our team. The successful candidate will be responsible for managing all credentialing activities related to privileges for our providers.

Key Responsibilities:
  • Maintain accurate and up-to-date provider demographic information, licenses, and certifications in our One_App database.
  • Complete hospital and insurance/payer applications for new providers and ensure timely updates as necessary.
  • Manage the CAQH database for providers and maintain accurate records.
  • Coordinate state licenses, state CDR, and DEA updates as required.
  • Ensure accurate and timely updates to insurance company location and provider listings.
  • Monitor and maintain Medicare 855 forms.
  • Collaborate with the Business Office to resolve insurance credentialing issues.
  • Monitor the Medical Affairs email account and respond to inquiries.
Requirements:
  • High school diploma or equivalent.
  • Minimum of two years of experience in healthcare-related credentialing and insurance/billing.
Preferred Qualifications:
  • Knowledge of credentialing database software.
  • Proficiency in documents and spreadsheet software.
  • Knowledge of medical terminology and office procedures.
  • Knowledge of third-party insurance operating procedures, regulations, and billing requirements.
Working Conditions:

This role requires frequent mobility and/or sitting for extended periods. Manual dexterity is required for using a calculator and computer keyboard. Some bending and stooping may be necessary.

This job description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.



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