Credentialing Specialist

Job Description

Job Description

Credentialing Specialist - Onsite ONLY - Teays Valley, West Virginia

Physical Requirements:

The employee is regularly required to talk, hear, and sit. Repetitive arm, hand, and finger movements are regularly required. The employee is frequently required to stand, walk, stoop, and reach. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.  This is NOT a remote position.

Qualifications:

High school graduate or equivalent. Excellent customer service, telephone, and computer skills. Knowledge of credentialing and re-credentialing process.

Basic Function:

Responsible for all aspects of the credentialing and re-credentialing processes for all providers who provide patient care at WomenCare Inc dba FamilyCare Health Center and all locations.

Duties and Responsibilities:

Site and Provider Credentialing:

• Complies and maintains current and accurate data for all providers
• Completes provider credentialing and re-credentialing applications, monitors applications and follow-up as needed
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
• Maintains provider contract files
• Maintains knowledge of current health plan requirements for credentialing providers
• Completes setup and maintains provider information in online credentialing databases
• Tracks license and certifications expiration for all providers
• Ensures practice addresses are current with all health plans
• Maintains collaborative agreements with providers
• All other duties as assigned