What are the responsibilities and job description for the Credentialing Specialist position at Omega Medical Billing Services?
Job Overview: This position entails communicating directly with the providers in person, via email and/ or via phone, as well as hospitals and/ or insurance companies. You will be responsible for enrolling and maintaining the participation status of the providers with hospitals and/ or insurance companies, as well as verifying demographic information and providing up to date licensures to ensure the most accurate information on file for the providers.
Responsibilities and Duties:
- Communicate with provider to obtain all documents necessary to credential
- Contact insurances and/or hospitals to initiate the application process
- Complete and submit hospital and/or insurance applications with all necessary signatures and
- applicable documents
- Communicate with the insurances and/or hospitals to follow up on the status of applications
- Complete and submit Electronic Remittance Advice and Electronic Funds Transfer forms
- Update and distribute Network List monthly
- Transfer letters in notes, scan and file
- Input detailed notes of daily activity in spreadsheet
- Verify, complete & submit provider demographic forms to insurances
- Send out updated licensures upon renewal to insurances and/or hospitals
- Maintain email volume, work in a timely manner
- Answer phone, attend call and/or route as needed
Qualifications:
- High School Diploma
- Six plus months office setting work experience