Credentialing Assistant

The Credentialing Assistant provide support for the credentialing and provider enrollment department.

 This position is responsible for creating and maintaining the Global Share electronic files and Excel data sheets; interact with health plans and/or facilities representatives for follow-up of credentialing activities; respond to faxed and emailed inquiries; document all activities in Verity CredentialStream and Teamwork.

Daily tasks and responsibilities include, but not limited to:


* Provides support and assistance for new practice setup as needed.


* Track progress of outstanding applications and communicate with provider relations representatives for follow-up ensuring enrollment completion.


* Maintains accurate and current information in the provider records in credentialing software database and in provider electronic folders. 


* Maintains credential files in an orderly and current manner. 


* Provides research and administrative support for special projects.


* Ensures HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities.
+ Create new credentials electronic files, save provider’s credentials to that file according to Global Share Filing Structure Policy, create new Practice and Provider Data Sheets.
+ Provider Credentials:  Maintain current credentials i.e.

medical licensure, DEA, COI’s, etc.

and set Verity CredentialStream reminders for notification of future expiration dates; maintain Provider Data Sheets with current credentialing information; maintain the credentials spreadsheet for the emergency and urgent care practices.
+ CAQH Re-attestation:  Maintain CAQH re-attestation spreadsheet and re-attest as required updating any expired credentials.
+ Incoming E-mail, Faxes:  Respond to requests for renewed credentials, W-9s, etc.
+ Maintain Electronic Files:  Update provider files with current information, documentation.
+ Credentialing Software:  Document all daily activities in Verity CredentalStream and Teamwork.
+ Change of Information:  Submit to health plans change of information letters and W-9s regarding practice moves, adding locations, changing remit addresses. 
+ Follow-up:  Make calls or send emails to health plans and/or medical facilities to check status of applications, change of information letters, or contracts.

Important Note: This Job Description is subject to any reasonable adjustment in accordance with the changing and developing needs of the position.