Credentialing Professional
3 days ago
**Job Title:** Credentialing Professional
About the Role:
Credentialing Professionals play a vital role in ensuring the integrity and compliance of medical professionals within our organization. This position is responsible for maintaining accurate and up-to-date information on providers, hospitals, and payers related to privileges for JWM Neurology PC providers.
Key Responsibilities:
- Maintain the One_App database with provider demographic information, licenses, DEA certificates, educational background, board status/certification, CMS status, Insurance credentialing status, liability insurance status/information, and work history.
- Complete hospital and insurance/payer applications for new providers.
- Update applications with hospitals and insurance/payers as necessary.
- Maintain the CAQH database for providers.
- Complete and update state licenses, state CDR, and DEA as needed.
- Update Insurance Company location and provider listings as appropriate.
- Maintain the Medicare 855 forms.
- Assist Business Office with insurance credentialing issues.
- Monitor the Medical Affairs email account.
Requirements:
• High School or equivalent.
• Minimum of two years of healthcare related credentialing experience, along with other insurance/billing experience in a medical office environment.
• Knowledge of documents and spreadsheet software desired.
• Strong analytical and problem-solving skills, with excellent communication and organizational abilities.
• Ability to recognize, evaluate, solve problems, and correct errors.
• Frequent mobility and/or sitting required for extended periods of time, with occasional manual dexterity for using a calculator and computer keyboard.
• Work performed in a busy office environment, requiring both desk and counter work, frequent contact with employees and outside agencies, and continual patient contact may involve dealing with angry or upset people.
Estimated Salary: $60,000 - $80,000 per year, based on qualifications and experience.
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