Job Description

Credentialing Specialist

• $20 to $27 depending on experience 

Job Description:
The Credentialing Specialist will be responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process.

• Liaise between the practitioners, health plans, hospitals, patient care facilities, and all related entities regarding credentialing, malpractice coverage, and practitioner enrollment.
• Manage credentialing and re-credentialing processes along with completing applications for respective Commercial, Medicaid, and Medicare healthcare plans; contacting doctors for additional documentation if required; monitoring applications for timely approval and follow-up as needed.
• Management of CAQH applications including completion and updates. Maintains provider information in online credentialing databases and systems.
• Responsible for all necessary updates including, but not limited to address changes, NPI updates, etc.
• Ensures facility addresses and provider information are current with health plans, agencies, and other entities.
• Coordinate, compile, and prepare reports pertaining to doctors as requested. Preparation of correspondence associated with the credentialing process.
• Maintains knowledge of current health plans and agencies' requirements for credentialing doctors.
• Tracks license and certification expirations for all practitioners to ensure timely renewals. Follow-up with practitioners regarding expiring documents to ensure compliance.
• Performs other duties as assigned.

Company Description:
To provide personalized, comprehensive care by integrating traditional wisdom with modern medical practices, ensuring each patient receives tailored treatments that address their unique physical, mental, and spiritual needs.

To provide personalized, comprehensive care by integrating traditional wisdom with modern medical practices, ensuring each patient receives tailored treatments that address their unique physical, mental, and spiritual needs.

Address:
Priority Family Care Center

2423 N. Broadway
LA CA 90031

Industry

Healthcare

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