Credentialing Specialist - Temporary
Credentialing Specialist - Temporary
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Job Description
Job Details
Description
As a Credentialing Specialist you are responsible for credentialing clinical and medical staff according to policy and regulation. You will maintain an accurate reliable credentialing status database for internal and external billing company use. This is a temporary position and is onsite in our Albany office.
Responsibilities:
- Maintain an updated shared database and Smartsheet with reminders and notice capability of all regulatory and agency required clinical/medical positions for which provide billable services or are required to register with Medicaid/Medicare based on their credential department and position.
- Work with organizational colleagues contractors and insurance and entitlement program representatives for credentialing all staff and independent contractors deemed necessary.
- Prepare appropriate credentialing packages provide list of required documents and information required to all staff and independent contractors deemed necessary. Schedule in person meetings or by approved online platforms if in person not possible according to credentialing grid timelines to ensure accurate filing of credentialing documents to all commercial insurers and entitlement programs with which we are in network.
- Complete credentialing applications to add providers to commercial payors and entitlement programs.
- Complete re-credentialing applications for commercial payors.
- Ensure appropriate rosters are filed with all facility-based insurers/plans.
- Maintain accurate and complete documentation of status of all active closed pending credentialing statuses by person/by license for each agency and location the provider will provide services.
- Provide CFO with weekly report of status of credentialing by program/provider for review with Chiefs.
- Monitor license and credential expiration dates provider electronic reminders of required renew by dates in advance according to applicable procedure.
- Ensure the agencies facilities and credentialed staff and contractors are maintaining compliance with regulatory and accrediting institutions.
- Maintain accurate provider profiles on all regulatory required credentialing sites including CAQH PECOS NPPES and CMS databases. This includes monitoring for providers who are removed or disassociated with our agencies facilities.
- Complete revalidation requests issued by government payers with appropriate program Chief CFO and Director of Revenue Cycle Management.
- Credentialing liaison to external billing company and company partners.
Requirements and Education:
- High School Diploma required Bachelors Degree preferred with minimum 3 years experience in credentialing recommended
About Northern Rivers
At Northern Rivers Family of Services we work together to make a difference in our clients lives. Northern Rivers empowers children adults and families to change their lives and build stronger communities.
Northern RiversFamily of Services is an Equal Opportunity Employer. We hire great people from a variety of backgrounds not because it is the right thing to do but because it makes us stronger! All applicants will be considered for employment without attention to race color religion sex orientation gender identity national origin veteran or disability status or any othercharacteristicprotected under applicable law. We cherishthe unique contributions of our diverse staff and are building a culture where everyone has the opportunity to do the meaningful work.
Required Experience:
Unclear Seniority
Employment Type
Temp
