Credentialing Assistant

Daily tasks and responsibilities include, but not limited to:


* Provides support and assistance for new practice setup as needed.


* Assist with the completing and submitting provider enrollment applications.


* 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 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 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.

Important Note: This Job Description is subject to any reasonable adjustment in accordance with the changing and developing needs of the position.