Credentialing Specialist (IN0775 - East Campus)

Job description

Responsible for processing privileging/credentialing/contract applications for organization, sites and providers, in accordance with department expectations. Works closely with Chief of Clinical Affairs and Clinical Officers, Chief Revenue Officer, Billing Manager, and Credentialing Team Lead, ensuring the privileging/credentialing/contracting process is completed correctly, within establish timeframes. This will include, but not limited to responsibility of contracting with health plans, privileging/credentialing new and established health care providers/sites, and maintenance of information to include primary source verification, follow up, data collection, data entry, and document review. DUTIES AND RESPONSIBILITIES: 1. Initiates and reviews privileging/credentialing/contract applications, conducts background checks and maintains primary source and federal loan verifications and queries, ensuring completeness, identifying discrepancies and potential issues, maintaining compliance with Center policies and procedures, federal and state regulatory and accrediting agencies. 2. Responsible for timely and accurate multi-system data entry of health plan/location/provider additions, del...