Responsible for all aspects of the credentialing, re-credentialing and privileging processes for providers with contracted insurance companies and other accrediting entities.  Maintain current data for each provider to ensure timely renewal of credentialing, licensing and certification.  

 

Complete provider credentialing and re-credentialing application with contracted insurance companies and other accrediting entities.

Ensure all credentialing applications and forms are completed accurately, thoroughly and timely.

Monitor the status of each provider’s credentialing and re-credentialing application and forms.       Follow-up with credentialing entities to ensure provider credentialing is completed timely.

Communicate status of provider credentialing to applicable practices and Administration.

Set up and maintain provider and practice information in online credentialing databases.

Contact and follow-up with providers to ensure all pertinent information is received to process credentialing, re-credentialing and accreditation to ensure timely filing and renewals.

Maintain credentialing files and documentation.

Maintain knowledge of credentialing guidelines and office participation and non-participation with insurance companies

Post and reconcile all payments received for clinic billing.

Prepare month-end payment reconciliation reports for clinics billing.