Credentialing Specialist - Community Healthcare
<p><strong>Community Health Center in the metro Phoenix area is seeking an experienced Credentialing Specialist.</strong></p><p><strong>Overview:</strong> Credentialing Specialist will coordinates activities related to credentialing services. Coordinates the application process to meet the requirements of the applicable regulatory agencies, insurance companies and etc. Will also coordinates the reappointment process of the Medical Staff to meet the requirements applicable regulatory agencies. Assists with administrative needs of the Medical Staff. Responsible for maintaining confidentiality with respect to all Medical Staff. Provides support for the Information Management Systems.<strong></strong></p><p><strong><span style="text-decoration: underline;">Duties and Responsibilities</span></strong></p><ul><li>Ensures providers are credentialed, appointed, and privileged.</li><li>Maintains up-to-date data for each provider in credentialing databases and online systems.</li><li>Ensures timely renewal of licenses and certifications.</li><li>Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.</li><li>Maintains copies of all current documentation.</li></ul><ul><li>Acquires knowledge of current health plan and agency requirements for credentialing providers.</li><li>Tracks license and certification expirations for all providers to ensure timely renewals.</li><li>Assists in auditing delegated credentialing functions in accordance with policies and procedures.</li><li>Audits files for completed information upon submission, requests missing data from providers.</li><li>Completes E-verify and New Hire Reporting on any new employees.</li><li>Maintains strict confidentiality of client, company, and personnel information.</li></ul>