Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and recredentialing 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.3
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Sets up and maintains provider information in online credentialing databases and system.
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies and other entities.
- Tracks license, DEA and professional liability expirations for healthcare providers
- Maintains appointment files, and information in credentialing database.
- Audits health plan directories for current and accurate provider information.
Ability to maintain confidentiality and discretion in all communications on behalf of credentialing applicants and/or applications.
- Provides credentialing and privileging verifications.
- Performs other duties as assigned.
Knowledge and understanding of provider credentialing and its direct impact on the practice’s revenue cycle
- Excellent verbal and written communication skills including, letters, memos and emails.
- Excellent attention to detail.
- With at least 1-2 years of customer service or administrative experience preferably in a high-volume call centre, or customer focused administrative position.
- 2 years’ experience credentialing experience preferred