Credentialing Assistant

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 r & CredentialMyDoc 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, CredentialMyDoc 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.