Credentialing Assistant

1 week ago

Cebu City, Central Visayas, Philippines Harris Computer Full time $30,000 - $50,000 per year

Daily Tasks And Responsibilities Include, But Not Limited To

  • Provides support and assistance for new practice setup as needed.
  • Track progress of outstanding applications and communicate with provider relations representatives for follow-up ensuring enrollment completion.
  • Maintains accurate and current information in the provider records in credentialing software database and in provider electronic folders.
  • Maintains credential files in an orderly and current manner.
  • Provides research and administrative support for special projects.

  • Ensures HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities.

  • Create new credentials electronic files, save provider's credentials to that file according to Global Share Filing Structure Policy, create new Practice and Provider Data Sheets.

  • Provider Credentials: Maintain current credentials i.e. medical licensure, DEA, COI's, etc. and set Verity CredentialStream reminders for notification of future expiration dates; maintain Provider Data Sheets with current credentialing information; maintain the credentials spreadsheet for the emergency and urgent care practices.
  • CAQH Re-attestation: Maintain CAQH re-attestation spreadsheet and re-attest as required updating any expired credentials.
  • Incoming E-mail, Faxes: Respond to requests for renewed credentials, W-9s, etc.
  • Maintain Electronic Files: Update provider files with current information, documentation.
  • Credentialing Software: Document all daily activities in Verity CredentalStream and Teamwork.
  • Change of Information: Submit to health plans change of information letters and W-9s regarding practice moves, adding locations, changing remit addresses.
  • Follow-up: Make calls or send emails to health plans and/or medical facilities to check status of applications, change of information letters, or contracts.

Qualifications And Requirements

  • Preferably College Graduate or at least 2 years in College.
  • Degrees and Courses related to Medical Field is a plus.
  • Strong written and verbal communication skills.
  • Ability to work effectively with minimal supervision.
  • Ability to work with confidential information.
  • Detail oriented.
  • Proficient in the use of email.
  • Highly motivated self-starter.
  • Organized, able to set priorities and meet deadlines.
  • Dependable and reliable.
  • Team player being supportive of Department and Company goals and policies.
  • Must be flexible with schedule.
  • Previous call center experience related to Medical Accounts and Programs is a plus.

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