Posted on: June 12, 2021
Summary of Job
Responsible for preparing provider enrollment applications,
demographic updates and tracking metrics for all eligible provider
types. Ensure enrollment activities meets federal, state and
department guidelines when processing application submissions.
Maintain up-to-date data for each provider in credentialing
databases and online systems; ensure timely renewal of licenses and
certifications. Reports to Director of Credentialing and CVO.
Essential Duties and Responsibilities
- Provides support Credentialing Account Manager.
- Compiles and maintains current and accurate data for all
- Completes provider enrollment credentialing and
re-credentialing applications; monitors applications and follows-up
- Build knowledge base for payer requirements and forms.
- Assist with filing, scanning and mailing as needed.
- Maintains copies of current state licenses, DEA certificates,
malpractice coverage and any other required credentialing documents
for all providers.
- Prepare and send provider demographic updates.
- Track license and certification expirations for all providers
to ensure timely renewals.
- Generate and send sign pages/application to client.
- Additional projects as assigned.
- Understanding and knowledge of the credentialing and provider
- Must be able to organize and prioritize work and manage
- Excellent verbal and written communication skills including,
letters, memos and emails.
- Excellent attention to detail.
- Ability to research and analyze data.
- Ability to work independently with minimal supervision.
- Ability to establish and maintain effective working
relationships with providers, management, staff, and contacts
outside the organization.
Bachelor's degree preferred OR two years of relevant
Employees are required to speak, read and write English
Physical Demands / Work Environment
Must be able to lift 50 lbs. and sit for extended periods of
Keywords: e-MDs, Westport , Credentialing Specialist, Other , Hauppauge, Connecticut
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