Credentialing Coordinator

Job Summary

Responsible for insurance payor and facility credentialing for private physician practice. Responsible for obtaining provider information for all professional billing, facility enrollment for new providers and re-credentialing. Responsible for providing updated billing information to appropriate carriers to obtain and maintaining provider numbers for insurance payors.

Job Responsibilities

• Receive and process medical staff applications and re-applications for insurance payors and facilities.

• Maintains physician licensing to include medical licenses and DEA registrations

• Responsible for new provider credentialing and re-credentialing

• Provides credentialing updates to billing team

• Coordinates information flow between two or more departments

• Investigate and resolve credentialing issues identified from rejected claims.

Education

Required: High School Graduate or equivalent

Experience

Required: 3 years in Medical Staff support role