Job Description

Key Responsibilities:

Job Description:

• Responsible for all aspects of new and existing provider credentialing and re-credentialing including initial application for all providers.
• Complete credentialing applications to add providers to commercial payers, and Medicaid.
• Review credentialing application for completeness and log any missing documentation
• License Renewals: Ensures that physician licenses are renewed prior to expiration.
• Records Management: Maintains assigned physician files, updating each item/action as processed

• Ensure that information is current and accurate and ensure appropriate follow-up with Insurance carriers
• Knowledge and experience with CAQH, Availity, NPI type 1 and 2.
• Maintain confidential and sensitive information with discretion.
• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases

Required knowledge, skills and abilities:

• Knowledge of provider credentialing with a minimum of two years of previous experience preferred
• Excellent computer skills including Excel, Word, and Internet use 
• Detail oriented with above average organizational skills 
• Plans and prioritizes to meet deadlines 
• Communicates clearly and effectively
• Strong attention to detail and ability to manage multiple tasks simultaneously
• Excellent communication and interpersonal skills, with the ability to work collaboratively with staff and providers.

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