Credentialing Specialist Job Vacancy in Confidential Auburn Hills, MI 48326 – Latest Jobs in Auburn Hills, MI 48326
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Company Name : Confidential
Location : Auburn Hills, MI 48326
Position : Credentialing Specialist
Job Description : Credentialing Specialist’s primary job is to ensure that all heath care providers are credentialed and contracted with the appropriate payers. In addition, it is the credentialing specialist’s responsibility to be sure all provider privileges are active and maintained. A Credentialing Specialist keeps track of all provider data and documents. One aspect of this position involves completing detailed applications for both payers and facilities.In addition to initiating and maintaining provider credentialing, it will be the credentialing specialist’s responsibility to keep thorough records of all current tasks. This will insure adequate and complete information in order to update managers.Duties and responsibilitiesMaintain provider filesInitial and re-credentialing of providers with payersInitial and re-credentialing of providers with facilitiesKeep track of important datesEDI set upReview contracts and fee schedules periodicallyUpdate providers, management, and co-workers on new credentialing informationKeep updated on healthcare credentials, medical licensing and certification requirementsAssess Facility Practices, review facility-specific rules and regulations for compliance with internal processesAuditing paperwork such as applications and licensing documentation for accuracyProcessing privilege requests for providersUnderstanding of current healthcare laws and regulationsRecognize and understand credentialing guidelinesMaintain an updated database – track licensing, compliance with federal standards, completion of necessary training and continued educationContinue regular communication with Manager and Practice AdministratorOther duties as assignedEducation/Experience/CertificationsHigh school DiplomaAssociates degree or the equivalent of 2 years’ experienceExperience in credentialing of 2 years requiredKnowledge of payor policies and processes required.Qualifications· Knowledge of computer programs· Knowledge of credentialing procedures· Ability to operate a computer and basic office equipment· Ability to read, understand and follow oral and written instructions.Looking for 25 hours a week – three days. Days can be flexible.Job Type: Part-timeBenefits:401(k)Employee assistance programFlexible scheduleSchedule:Day shiftWork Location: One location
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