Credentialing Specialist Physician Billing (13409)
| Responsible for credentialing and maintaining high quality and accurate information for new and established healthcare providers in a timely manner per the Medical Staff policies and procedures. |
| Process and maintain credentialing and re-credentialing in accordance with Medical Staff policy and procedure, Joint Commission standards, State and Federal Regulatory regulations. |
| Identify and evaluate potential red flags and work in collaboration with practitioner to document the issue and physician response. |
| Ensure provider enrollment and maintenance with CAQH and PECOS. |
| Responsible for payor enrollment and re-enrollment to assure claim acceptance. |
| Coordinate with Medical Staff credentialing to obtain information and avoid duplication of efforts. |
| Demonstrates and encourages team behavior and exceptional patient/guest experiences. |
| Upholds and promotes patient safety and quality. |
| Fulfills duties of a Billing Specialist in accordance with provider and/or clinic assignment. |