What are the responsibilities and job description for the CREDENTIALING SPECIALIST - Remote position at OrthoAlliance?
The Credentialing Specialist is responsible for facilitating credentialing and provider enrollment processes for all assigned offices and providers within the OrthoAlliance team. Individuals will be responsible for ensuring that documentation is kept up-to-date as well as ensuring that all providers are current with licensure, malpractice insurance as well as DEA.
Type: Full Time
Location: Remote/Work from Home
Travel: Must be able to be in Muncie, IN for initial and quarterly trainings. Although this position is remote, coming to Muncie periodically is required, and not eligible for mileage reimbursement.
Schedule: 40 hrs/week, M-F
Responsibilities:
- Responsible for corporate-wide credentialing (facility appointments and reappointments) and provider enrollment with payers of all medical professionals including MDs, PAs, APRNs, PTs, OTs, and others as needed.
- Maintain, secure, and update all credentialing files.
- Ensures timely processing of all credentialing requests.
- Assure all new providers are credentialed and enrolled with payers in advance of starting at OrthoAlliance when possible.
- Facilitate provider credentialing, obtaining required information as needed. Coordinates procurement of DEA, licensure, malpractice insurance information, and other required information to process applications.
- Utilize and update the MD-Staff database and CAQH to assure all credentialing information is accurate and up-to-date.
- Maintain and update credentialing dashboards. Keeps an updated log of all pending and completed work.
- Research and resolve all credentialing issues. Following up on applications as needed.
- Communicates effectively with providers, management, and team members.
- Places a high priority on and maintains strict confidentiality in all situations.
- Participates in professional development activities and maintains applicable professional affiliations and certifications as required.
- Attends and participates in required organizational meetings and committees as requested.
- Perform additional related duties as assigned.
Education:
- Minimum of high school diploma or GED required, college course work or Bachelor's degree preferred.
- Medical office experience required.
- 2-3 years of experience in credentialing or equivalent work experience preferred.
Working Conditions:
Standard work environment is an office setting. Work requires sitting for long periods of time. Position requires viewing and typing on a computer for long periods. Occasionally bending, lifting, and reaching required to deal with files, paper, supplies, etc., including lifting up to 50 pounds. Requires manual dexterity sufficient to operate standard office equipment (computer, telephone, copier, etc.) regularly. Vision must be correctable to 20/20. Hearing must be in the normal range for telephone contacts and to interact directly with employees. Occasional evening or weekend work may be required. Work may be stressful at times. Regularly interacts with the staff, physicians, business associates, and the public, which may include sick or injured people.
Experience
Preferred- Medical office experience and/or 2-3 years of experience in credentialing or equivalent work experience preferred.
Education
Required- High School or better
- Associates or better
