Medical Credentialing Specialist

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TYPE OF WORK

Freelance

SALARY

350 PHP/$6 HOURLY

ID PROOF

65

DATE POSTED

Oct 07, 2022

JOB OVERVIEW

Disclaimer: If you apply without relevant experience OR following instructions, you will be reported and may be banned from this job board.
Application Instructions:
1. Ensure that you meet criteria (or you will be reported)
2. Attach resume/CV
3. Answer this question in your application: What is your main strength? What is your main weakness?

Position Summary: Provides administrative and support services for the recruiting and credentialing functions of CCNI Providers for Medicare, Medicaid and CAQH enrollment and revalidation; management of effective dates with all plans; new provider on-boarding responsibilities from initial contact with recruiting firms to the providers start date.

RESPONSIBILITIES:
Duties may include but are not limited to:

- Initiate and support the practitioner application process by sending, receiving, and analyzing practitioner documents and data import to determine completeness in preparation for the credential’s verification process.

- Responsible for gathering, verifying highly confidential and sensitive health care practitioner credentials consistent with departmental guidelines and accreditation standards

- Efficiently perform all aspects of credentialing verification, including initial credentialing and recredentialing 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 in a timely manner

- Monitor expiring licensure, board, and professional certifications and other expirable documents with practitioners within the prescribed timeframe

- Responsible for accurate data entry to endure 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 during the credentialing process

- Use critical thinking skills to conduct follow-up with individual practitioners and internal and external entities to resolve discrepancies identified during the credentialing process.

Hours will range from 5-30 hours weekly. This is a part-time position and we are completely open to employees having another part-time position as long as all work is completed.

SKILL SUMMARY
Professional Services
Medical Services
Project Management
Other Project Management
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