What are the responsibilities and job description for the Credentialing Specialist position at Azalea Health Innovations Inc?
Job Description
Job Description
IN SUMMARY...
The Credentialing Specialist is responsible for credentialing and recredentialing providers contracted with the company. Provides integral support to healthcare operations by enabling timely onboarding of healthcare providers. Credentialing functions include, but are not limited to, processing credentialing applications, updating and maintaining credentialing database in accordance with internal policies and procedures, CAQH maintenance, and complying with applicable state and federal requirements
WHAT YOU WILL DO...
- Initiate and support the practitioner application process by sending, receiving, and analyzing practitioner documents and data import to determine completeness in preparation for the payor application process.
- Efficiently perform all aspects of initial credentialing and recredentialing process to ensure current credentials and timely handoff and / or review and approval of practitioner files.
- Respond to all practitioner, client health plan and internal inquiries within 1 business day.
- Maintain electronic data files for CAQH to submit practitioner data, as required.
- Responsible for accurate data entry to ensure the integrity of credentialing information in applicable database(s).
- Collaborate with participating clients, department manager and / or external agencies to facilitate and ensure smooth hand-off from enrollment completion to billing.
- Submit tasks for invoicing.
- Use critical thinking skills to conduct follow-up with individual practitioners and internal and external entities to resolve discrepancies identified during the credentialing process.
- Actively participate in team meetings and process improvement initiatives to continuously improve work product quality and efficiency.
- Keep Manager informed of potential credentialing or enrollment issues.
- Perform duties in a timely manner as required by clients and company.
- Azalea advocate at all times.
- Other duties, as assigned.
BACKGROUND AND SKILLS YOU WILL BRING...
SUCCESS LOOKS LIKE...
HOW WE INVEST IN YOU...
Generous employer sponsored subsidy towards employee's medical insurance premiums
Azalea Health's EEO Statement
Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.