DESCRIPTION OF POSITION:
- Works with Hospital Administration as a liaison with the Medical Staff and Insurance Payers. Plans, develops, organizes, and controls the operation of the Provider Enrollment to insure that providers are enrolled in all reimbursement agencies and remain current. Credentialing Specialist will to contribute to meeting the mission and goals of the Hospital and to meet the requirements of the Medical Staff Bylaws, JCAHO Standards, and other applicable federal, state, and local regulatory and/or accrediting agencies.
RESPONSIBILITIES AND DUTIES:
- Maintains all websites for providers.
- Maintains spreadsheets of provider information.
- Credentialing/recredentialing for all providers.
- Utilizes AllScripts
- Follow up with Payors
- Maintains all provider documentation used for credentialing
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.
EDUCATION AND WORK EXPERIENCE
- High School Diploma or GED
- 1 year Credentialing experience preferred
- Ability to read, write and speak intelligible English
- Requires emotional stability and resilience; Exhibits organizational and leadership ability; Able to understand and relate to specific ideas generally, several at a time, and remember multiple tasks given to self and others over long periods of time.
Physical Demands/Work Environment
- Work requires light duty lifting.
- Must be able to remain in a stationary position 50% of the time.
- Constantly operates a computer and other office machinery such as calculator, copy machine, and computer printer.
- Must be able to exchange accurate information with patient, family, peers and medical personnel.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.