Credentialing Specialist
Credentialing Specialist
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Job Description
Ensures regulatory compliance with Mayo Clinic accreditation and regulatory agencies in the coordination of initial credentialing appointment and related hiring processes to meet the needs of patients and achieve financial commitments.
Coordinates the initial and reappointment processes to ensure compliance with Mayo Clinic accreditation and regulatory agencies. Provides direction and consultation on credentialing privileging payer/provider enrollment and licensure related policies and regulations between providers and departments state licensing boards Medicare and Medicaid commercial payers physicians administrators and operation managers. Coordinates and ensures internal and regulatory compliance with clinical privileging and payer enrollment. Actively participates in accreditation government state Department of Health surveys and payer audits. Maintains industry knowledge of accreditation and regulatory standards and government regulations for payer enrollment. Actively participates in the delegated credentialing activities to ensure third-party reimbursement. Works to develop and enhance credentialing processes and compliance. Coordinates licensure and licensure compliance-related items for providers. Coordinates provider compliance of licensure DEA board certification renewals along with other regulatory requirements. Trains and mentors new credentialing personnel. Exhibits strong problem-solving analytic skills and independent decision-making abilities. Consistently exhibits behavior and communication skills that demonstrate Mayo Clinics commitment to superior customer service.
This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
Qualifications
Associate degree and 3 years administrative assistant or related experience in a healthcare environment or 5 years administrative assistant or related experience. Associate or Bachelors degree in a business-related field is preferred.
Superior customer service skill and communication skills written and oral with the ability to communicate to all levels of personnel. Excellent organizational and analytical skills. Self-motivated able to prioritize multiple assignments ability to track multiple projects/tasks and follow through as needed. Ability to work well independently in a fast changing environment and with others in a team environment. Detailed-oriented individual. Computer proficient and strong computer skills in Microsoft Office (e.g. Word Excel etc). Willingness to enhance knowledge and skills by obtaining appropriate training. Must be able to work collaboratively with internal and external customers.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
