What are the responsibilities and job description for the Credentialing Specialist position at Clearview Cancer Institute?
Job Purpose
The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, commercial payers, Medicare, and Medicaid.
Essential Job Functions
- Maintain individual provider files to include up to date information needed to complete the required
- governmental and commercial payer credentialing applications
- Update each provider’s CAQH database file timely according to the schedule published by CMS
- Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance
- Complete revalidation requests issued by government payers
- Complete credentialing/re-credentialing applications to add providers to commercial payers, Medicare, and Medicaid
- Credential new providers and re-credential current providers with hospitals at which they hold staff privileges
- Maintaining online document storage; labeling and updating paper files
- Other duties as assigned
Qualifications
- Knowledge of provider credentialing
- Excellent computer skills including Excel, SharePoint, Word, and Internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
Education/Experience
- High School Diploma or GED
- 2 years credentialing experience preferred
- 2 years medical office experience required
Working conditions
This position works in a busy hematology/oncology clinic but has no direct patient contact. This person is responsible for the credentialing of physicians and physician extenders so interaction with both is required.
Physical requirements
This position requires the employee be able to sit at a desk for up to eight hours a day. It also requires standing and walking for up to two-thirds of the day on some days in order to complete tasks.
Direct reports
This is not a supervisory position.