Create and carry out various credentialing processes in relation to Ambulance Services, both Public and Private. Process Medicare and Medicaid applications and revalidation paperwork, checking for completeness and accuracy. Collect and process significant amounts of verification and accreditation information, and thus must constantly maintain and update accurate records for providers. Communicate status of credentialing throughout the organization to aid in onboarding of new providers.
Responsibilities and Duties
- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and Revalidation applications; monitors applications and follows-up as needed.
- Maintains copies of any required credentialing documents for all providers.
- Maintains corporate provider contract files.
- Sets up and maintains provider information in online credentialing databases and system.
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Ensures provider addresses are current with health plans, agencies and other entities.
Qualifications and Skills
- Knowledge and understanding of the Medicare and Medicaid credentialing process.
- Ability to organize and prioritize work and manage multiple priorities.
- Excellent verbal and written communication skills including, letters, memos and emails.
- Excellent attention to detail.
- Ability to research and analyze data.
- Ability to work independently with minimal supervision.
- Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
- Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.
High school diploma or equivalent.
Associate degree preferred.
Certified Provider Credentialing Specialist (CPCS) preferred.
- Medical Credentialing: 2 years
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