Credentialing Specialist

Company: Crisis Preparation & Recovery
Location: Tempe
Posted on: May 13, 2022

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