Credentialing Coordinator
- Completes accurate enrollment application for new providers in a timely manner.
- Maintains accurate information with regards to the re-enrollment standards for all payers.
- Submits re-enrollment applications in a timely manner to ensure that providers are up to date with their re-enrollment status.
- Follow up with the contractual insurance carriers regarding provider/facility enrollment/termination/relocation status.
- Enroll all providers in CAQH and provide re-attestations as needed.
- Issues monthly reports from the Credentialing Software Database to ensure proper communication regarding provider status related to enrollment.
- Provides additional status reports and updates as needed.
- Updates the appropriate provider enrollment matrix.
- Tracks progress of outstanding applications and informs the appropriate parties of in network effective dates.
- Proactively communicates with Human Resources in regards to the needs/requirements of the enrollment department as it relates to provider information.
- Works closely with providers to obtain necessary documentation.
- Assists providers in obtaining/updating an NPI number.
- Collaborates with the billing department to resolve any provider based denial issues related to the enrollment process.
- Communicates with appropriate billing staff regarding the status of a provider’s enrollment with individual payers. Any significant delays must be reported to management
- Assists with the maintenance of the Practitioner Enrollment forms in all Electronic Health Records in a timely manner.
- Treat patients with care, dignity, and compassion
- Respect patients’ privacy and confidentiality
- Is pleasant and cooperative with others
- Assist patients and visitors as needed.
- Personal values don’t inhibit ability to relate and care for others
- Is sensitive to the patient’s needs, expectations and individual differences.
- Is gentle and calm with patients, families, and others as appropriate.
- Actively participate in Performance Improvement activities
- Actively participate in AHS committees as requested
- Complete assigned tasks in a timely manner
- Follow AHS policies and procedures
- Receive and respond to inquiries of billing matters promptly and courteously.
- Assist with performance of duties of other staff in periods of absence.
- Perform other duties as assigned by supervisor.
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