Credentialing Assistant

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.
Qualifications and Requirements
●    Preferably College Graduate or at least 2 years in College.
●    Degrees and Courses related to Medical Field is a plus.
●    Strong written and verbal communication skills.
●    Ability to work effectively with minimal supervision.
●    Ability to work with confidential information.
●    Detail oriented.
●    Proficient in the use of email.
●    Highly motivated self-starter.
●    Organized, able to set priorities and meet deadlines.
●    Dependable and reliable.
●    Team player being supportive of Department and Company goals and policies.
●    Must be flexible with schedule.
●    Previous call center experience related to Medical Accounts and Programs is a plus.