Credentialing Specialist
Company: Crisis Preparation & Recovery
Location: Tempe
Posted on: May 13, 2022
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Job Description:
The Credentialing Specialist is responsible for processing
credentialing and recredentialing applications of health care
providers, maintains internal databases, contacting insurance
carriers to complete credentialing and recredentialing
applications. This position ensures the Credentialing department
fulfills its dual purpose of quality control and customer service.
This is physician, clinician and nursing related and includes CAQH
maintenance, CMS applications, renewal of DEA and other licenses
and maintenance of provider files.Knowledge and
Skills:Communication skills: Due to the nature of behavioral
health, communication must be professional, clear, calm, and
sensitive at all times regardless of the
circumstances.Multi-tasking skills: Must develop and demonstrate
superb multi-tasking skills to effectively accomplish multiple
required and competing tasks.Phone and computer literacy: Must
maintain minimal phone and computer handling skills. Minimal typing
by touch skills are necessary in order to properly documentOther
skills: a background in credentialing (highly preferred) or health
care administration (preferred) and email/phone etiquette
Duties:Checking OIG website for any provider, or CPR personnel who
are in direct contact with patientsMonitoring AHCCCS ID numbers for
activeness and alerting manager if showing not activeUpdating ID
number spreadsheets for each Insurance PanelMonitoring and
responding to email and phone calls in a timely mannerMaintaining
professional phone and email etiquette Insurance Panels online
roster checked once every three monthsKeeping track of
communication regarding the timeliness of returned forms from
providers. Learn procedures for various insurance panels as
neededCommunicate with management when a provider or group of
providers has been credentialedPrepares and submits appropriate
paperwork and documentation for new credentialing and the
recertification or additional information requests of existing
credentialed staffTracks providers expirables Re-attesting the CAQH
profile of providersOther duties as assigned Qualifications and
Education RequirementsHigh School or GED Diploma required2 year
degree or some college preferred #IND PI177521282
Keywords: Crisis Preparation & Recovery, Tempe , Credentialing Specialist, Other , Tempe, Arizona
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