What are the responsibilities and job description for the CREDENTIALING ASSOCIATE position at Bienville Orthopaedic Specialists?
Essential Job Duties
- Complete provider initial and re-credentialing applications and submit with supporting documentation to all requested payers, hospitals, and ASCs
- Monitor application progress and follow up with payers until “in network” status has been confirmed/received
- Revalidation and recredentialing requests issued by government payers
- Maintain copies of providers’ required credentialing documents (current state licenses, DEA certificates, malpractice coverage, etc.)
- Track all state/medical licenses, DEA, and Board Certification/Recertification expirations; assist providers with renewals to ensure they are completed in a timely manner.
- Track CME and send quarterly updates to providers.
- Maintain Physician Extender (PE) Compliance and ensure that Audit Ready files remain up to date
- Renew MACM applications yearly, track expenses for providers and renew memberships/subscriptions
- Oversee malpractice claims and communicate with MACM, attorneys, and provider(s)
- Manage provider data via online databases and systems such as CAQH, PECOS, NPPES, etc.
- Responsible for PrimeSource Verification of State license, DEA, and Board Certification
- Assist physicians with ABOS WLA each year
- Manage Resident Rotations for BOS providers who participate in Memorial Hospital’s Family Medicine program
- Create, manage, and maintain emergency department on-call schedule for physicians using prior year’s call schedule as reference
- Primary liaison for call schedule changes between Bienville physicians, hospital staff, and Bienville’s answering service to ensure 24/7 coverage
- Assist with administrative assistant duties and other duties as assigned/needed
Additional Requirements:
- Excellent verbal and written communication skills
- Must demonstrate a high degree of trust and confidentiality
- Must get along well with others and have a team-oriented work ethic
- Ability to work independently and assume assigned responsibilities
- Ability to be flexible and function well in a fast-paced environment with multiple interruptions
- Must be able to travel to all clinic locations and work overtime as needed
Position is Full Time, Non-exempt, Hourly
Work Hours: Monday - Friday 8am-5pm (Occasional after hours support if needed)