Credentialing Specialist
Overview of Position
Primarily responsible for day-to-day tasks in Credentialing Dept. to include payer enrollment, revalidations, and other miscellaneous tasks as required by payers. Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of McKesson. Adheres to the McKesson HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
What will be my duties and responsibilities in this job?
- Complete the processes to credential physicians to meet payer criteria.
- Enroll clients with participating insurances.
- Input information to credentialing software in order to have most current data.
- Maintain filing of all necessary credentialing documentation.
- Follow up with clients and insurances in accordance with established guidelines for all credentialing assignments.
- Communicate client issues with management at an early stage.
- Be able to clearly and effectively communicate with physicians, physician staff, Operations Managers and insurance companies handling basic questions dealing with the day-to-day operation of credentialing and enrollments.
- Have prompt response time to voice mail, email and other requests whether it is from supervisors, co-workers or clients.
What are the requirements needed for this position?
- High school diploma or GED equivalent
- 1-year professional business experience.
- Medical billing or credentialing experience preferred.
- Have professional verbal and written communication skills.
- Work well under difficult circumstances and tight timelines.
- Know how to prioritize throughout the day as workflow changes.
- Perform all other tasks as requested by senior management.
What other skills/experience would be helpful to have?
- Time management: the ability to organize and manage multiple priorities
- Strong team player
- Excellent interpersonal and communication skills
- High performance
- Commitment to company values
- Computer proficiency
- Insurance billing experience