Medical office in Wellington, FL seeks highly self-motivated Credentialing Specialist with a proven expertise!.
Duties and Responsibilities:
Performs all aspects of credentialing activities to ensure effective operations, compliance with government/state regulations, and that all providers are appropriately credentialed
Accurately and timely completes all applications providing accompanying documents for credentialing and re-credentialing of practitioners
Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
Processes requests for privileges accurately
Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
Monitors the initial, reappointment and the expirable process for all providers, ensuring compliance with regulatory bodies
Handles the review and analysis of provider applications and accompanying documents, ensuring applicant eligibility.
Prepares credentials file for completion and presentation to Credentialing manager
Manage credentialing activities by gathering appropriate provider data, review due diligence documents and document all credentialing in appropriate files/records
Manage assignments, work flow and establishes priorities on a daily basis
Able to assist with contract acquisition and follow-up
Escalate issues to the appropriate members of the credentialing team, and/or co-workers as necessary to problem solve matters through clear communications.
Ensure proper follow up is completed ahead of deadlines