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Job Function :
Maintains physician credentials necessary to ensure initial and continued enrollment into participating insurance plans.
Job Function :
Follows up on credentialing applications per established follow up time frames. Alerts Credentialing Coordinator of any concerns.
Tracks applications and correspondence with insurance plans through to final completion.
Job Function :
Provides routine reports to physicians and support staff regarding the status of participation in insurance plans.
Job Function :
Updates and maintains the ECHO and CAQH databases.
Job Function :
Ongoing communication between Client's Health System divisions and billing company to ensure physician participation remains active
Job Function :
Provides updates to the Credentialing Manager regarding managed care plan credentialing procedure changes and other relevant information.
Job Function :
Establishes a rapport with managed care plan reps to enhance Client's Health System standing.
Job Function :
Establish a rapport with the practice coordinator / manager to gather missing items in order to ensure applications are released on time.
Job Function :
Maintain Provider Database. Add new providers when approved to release credentialing applications. Move providers who are no longer affiliated with Client's Medical Group to the second tab on spreadsheet.
Job Function :
Undertakes special projects and assignments as directed by the manager.
Last updated : 2024-04-23
Full Time
IT Outsourcing & Consulting
$45k-57k (estimate)
02/28/2024
05/11/2024
talentemail.com
Minneapolis, MN
50 - 100
IT Outsourcing & Consulting
The job skills required for Credentialing specialist include Confidentiality, Quality Assurance, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Credentialing specialist positions, which can be used as a reference in future career path planning. As a Credentialing specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing specialist. You can explore the career advancement for a Credentialing specialist below and select your interested title to get hiring information.
If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Credentialing Specialist job description and responsibilities
A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.
03/14/2022: Des Moines, IA
A credentialing specialist can have certificates that will prove useful to their field.
02/01/2022: Newark, NJ
Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
02/21/2022: Evansville, IN
Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.
02/01/2022: Las Cruces, NM
Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
01/18/2022: Pueblo, CO
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Credentialing Specialist jobs
Credentialing specialists can often find work with a high school diploma or the equivalent.
01/25/2022: Kingsport, TN
Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.
03/01/2022: Parkersburg, WV
While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.
12/25/2021: Little Rock, AR
Make Use Of Advanced Software For Monitoring.
01/18/2022: New London, CT
Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
01/31/2022: Portsmouth, OH
Step 3: View the best colleges and universities for Credentialing Specialist.