Credentialing Specialist
- Compiles and maintains current and accurate data for all provider and performs other duties as assigned.
- Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Maintains corporate provider contract files.
- Sets up and maintains provider information in online credentialing databases and system.
- Tracks expired licenses and certifications for all providers and practices to ensure timely renewals.
- Processes applications for appointment and reappointment of privileges.
- Tracks license, DEA and professional liability expirations for appointed providers and practices.
- Maintains Providers’ credentialing status with commercial insurances, Medicaid and Medicare; performs maintenance of practices credentialing status as assigned by supervisor.
- Completes credentialing and sends to Board of Directors for approval in a timely manner for all Providers, Advanced Practice Providers, and clinical staff as assigned by supervisor. Continuously monitors and maintains the FTCA credentialing spreadsheet to be sent in each year correctly for the HRSA grant application.
- Manage and administer CME (Continuing Medical Education) funds for medical, behavioral health, chiropractic, and dental providers.
- Provides special project support as assigned by supervisor.
- Patient First – An approach to care that holds primary, the well-being and desires of the patient
- Build not Blame – Focusing first on finding fault with the process rather than the person
- Integrity and Honesty – Fostering an acceptance of openness, honesty, and fairness in words, deeds and the use of organizational resources judiciously for both internal and external customers
- C ooperation and Flexibility – Related to an internal believe that we function as part of an interdependent team with only shared gains or losses thereby committed to assisting whenever possible beyond the prerequisite job description
- Culturally Sensitive – Always working toward increasing one’s ability to understand, communicate with, effectively interact and care for people across cultures, while having an acute awareness of one’s own culture.
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