- Responsible for credentialing and re-credentialing Physicians and Midlevel providers
- Adhering to credentialing timelines based on industry standards
- Creating and updating provider profiles in Verity software
- Conducting Primary Source Verification of Provider's information
- Reviewing Provider applications and requesting additional documentation when needed
- Maintaining knowledge of credentialing delegation requirements
- Organizing and monitoring credentialing files
- Ensuring timely renewals of licensure and certifications
- Supporting annual review processes
- Collaborating with payors for updated demographic information
- Preparing files for the Credentialing Committee
- Prioritizing workload and managing workflow efficiently
- Performing other duties as required
- Minimum 2 years' experience in Credentialing or Health Care Industry
- High School Diploma required, Associates or Bachelor's Degree preferred
- Ability to analyze and apply standards to provider information
- Detail-oriented and organized
- Proficient in Outlook, Word, and Excel
- Strong written and oral communication skills
- Ability to multitask and prioritize effectively
- Knowledgeable on HIPAA/Confidentiality guidelines
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Credentialing Associate - Miami, United States - Femwell Group Health
Description
Femwell Group Health is Florida's top management services organization (MSO) offering cost-effective solutions so doctors can efficiently manage their practices for better profitability.
Whether it's managed care support, accounting, or marketing, our team collaborates with physicians at every stage to boost productivity and enhance overall efficiency. We possess a deep understanding of the challenges in running a large physician group and have the expertise to support medical practices from inception to ongoing management.
Position/Title:
Credentialing Associate
Department:
Managed Care
Reporting to:
Vice President of Managed Care
Required Time Commitment (Full Time/Part Time):
Full time
Job Description:
The Credentialing Associate plays a vital role in fortifying relationships with insurance payers and physicians to meet service level expectations. Responsibilities include facilitating comprehensive credentialing and re‐credentialing processes for new and existing physicians and practices.
Primary Responsibilities:
Job Qualifications:
Femwell recruits for itself and independent practices. Practices and their employees are separate entities and not Femwell Agents or Employees. Femwell has no ownership over independent practices and does not influence hiring or medical decisions for them.
