Credentialing Specialist

1 day ago


New York, New York, United States Careers Integrated Resources Inc Full time
Credentialing Coordinator Job Description

Job Title: Credentialing Coordinator

Locations: New York, NY

Duration: 2 Months (with possible extension)

Shift Time: Hybrid: 9am to 5pm

Pay Range: $28 - $32/hr. on W2

Duties:

We are seeking a skilled Credentialing Coordinator to join our team at Careers Integrated Resources Inc. The successful candidate will be responsible for maintaining communication with credentialing contacts at facilities and provider sites to coordinate receipt of information required for credentialing, re-credentialing, and update of provider credentialing information.

The ideal candidate will review provider re-credentialing and credentialing files for completion and presentation to the Credentialing Committee. They will also perform primary source verification on required elements and in accordance with regulatory guidelines and client policies and procedures.

Key responsibilities include data entry and upkeep of provider information in credentialing and other pertinent databases, verifying New York State OProduct, Medicare/Medicaid lists, and other pertinent databases for any current sanctions, restrictions on licensure, and/or limitations on the Product of practice on all credentialed providers in interim credentialing periods.

The successful candidate will also verify New York State license registration and DEA registration status for all credentialed providers in the interim credentialing periods, generate and disseminate monthly provider credentialing updates to appropriate departments at client and participating facilities and provider groups.

Additional responsibilities include reviewing and responding to requests for credentialing information/copies of credentialing files to appropriate departments within client, generating and disseminating provider rosters to delegated facilities, contracted group practices, etc., performing provider roster reconciliation, creating, copying, filing, and maintaining all relevant documentation into provider credentialing folders.

The ideal candidate will maintain confidentiality of provider credentials by filing the credentialing folder in respective cabinets in the file rooms, perform annual delegated file audits, and participate in pre-delegation and delegation site reviews.

Responsibilities also include responding to inquiries from other client departments relative to a provider's credentialing status and performing other related tasks as directed by the Deputy Chief Operating Officer or her designee, the Credentialing Director or Credentialing Team Lead.



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