What are the responsibilities and job description for the Credentialing Specialist position at Global Consulting?
The Credentialing Specialist is responsible for screening and verifying the credentials, references, work experiences and other related items as well as maintaining all credentialing files for all providers and licensed professionals.
The Credentialing Specialist is responsible for screening and verifying the credentials, references, work experiences and other related items as well as maintaining all credentialing files for all providers and licensed professionals.
In addition insurance verification experience is required
Minimum Requirements: High School Graduate with at least two years of administrative/office experience plus prefer certification such as a Certified Provider Credentialing Specialist (CPCS) and/ or an Associates of Science Degree. Must have excellent organizational skills and communication skills both written and verbal. Ability to interface with medical staff both externally and internally as well as state and local government agencies. Must maintain confidentiality regarding medical and professional staff. High proficiency of use and understanding of PC, Windows and Spreadsheet applications.
Essential Functions
- Reviews and completes hospital and payor applications for all health care providers.
- Completes verification forms/letters for outside facilities.
- Maintain billing insurance grid, provider insurance grid, and each physician’s spreadsheet up to date on current insurance changes.
- Track and maintain physician licensure(s), certification, and CME credits.
- Maintain practitioner credentialing files.
- Maintain practitioner electronic file by keeping all applications/licensure current.
- Maintains all renewal applications for both hospitals/insurances.
- Has knowledge of Employee Handbook content along with established policies and procedures.
- Relies on instructions and pre-established guidelines to perform the functions of the job.
Job Types: Full-time, Part-time
Pay: $22.00 - $25.00 per hour
Expected hours: 20 – 40 per week
Benefits:
- 401(k)
- Paid time off
Ability to Commute:
- Wilmington, DE 19808 (Required)
Ability to Relocate:
- Wilmington, DE 19808: Relocate before starting work (Required)
Work Location: In person
Salary : $22 - $25
