Job Description
JOB TITLE: Certified Credentialing Specialist ASC JOB SUMMARY The primary responsibilities are to perform administrative and technical tasks pertaining to credentialing new providers and maintaining credentials for current providers at the ASC.
JOB DESCRIPTION - Completes practitioners' applications/reapplications
- Responds to requests from insurance companies for information/documentation
- Follows up with insurance companies and hospitals regarding status of practitioner's applications
- Notifies insurance carriers when a practitioner leaves the practice
- Notifies insurance carriers when a new practitioner joins the practice
- Tracks information to promote speed of processing
- Processes change of addresses for each practitioner/practice location
- Manages renewals of medical licenses, DEA's, occupational licenses for all practitioners
- Maintains the NPI (National Provider Identifier) and CAQH (Council for Affordable Quality Healthcare) data bases
- Apply for and maintain I&A (Identity & Access), and PECOS Provider information
- Works with malpractice insurer to obtain initial and practitioners and renewal coverage
- Maintains a current electronic insurance grid identifying the credentialing status of all practitioners for contracted payers and government agencies
- Maintains a resource file on each practitioner
JOB REQUIREMENTS - High school graduate or GED equivalent
- Minimum 1 year experience in credentialing
- Strong aptitude for customer service and telephone etiquette
- Organized, detail-oriented, and diligent work ethic
- Proficient in Word ,Excel, Adobe (PDF), Outlook
- Knowledge of CAQH and I&A, PECOS/CMS applications
- Notary Public, preferred not mandatory
- Credentialing Specialist Certification (CPCS) Preferred
KNOWLEDGE, SKILLS, AND ABILITIES - Working knowledge of CAQH (Council for Affordable Quality Healthcare) and I&A, PECOS/CMS applications
- Excellent written, oral communication, analytical skills, and customer relations
- Ability to organize, prioritize, and effectively work on multiple projects at one time
- Ability to read and communicate effectively in English. Additional languages preferred
- Ability to communicate in a professional manner, able to counsel/teach customers, train co-workers, and positively contribute to marketing/public relations
- Ability to respond to common inquiries or complaints from patients, regulatory agencies, or members of the medical and business community
- Must be able to work in an environment where production goals are set to be achieved
HOURS AND WORKING CONDITIONS Located in Tampa, FL and is open Monday through Saturday. Position has the potential for being hybrid remote and on site. Requires sitting and standing associated with normal office environment.
Noise or Vibrations: Copy machine, phones, computer and printer, other office equipment
Job Tags
Part time, Work at office, Remote work, Saturday,