Data Entry, Data Quality, Database Administration, Document Management, File Maintenance, Hospital, Insurance, Onboarding, Professional License, Reporting Skills
LOCATION
Baltimore, MD
POSTED
4 days ago
Job Title: Credentialing Specialist
Location: Baltimore, MD
Local, Remote or Hybrid: Local
Schedule: Onsite, Mon-Fri 8:30am-5pm
Contract: 26 weeks
Required Qualifications
Education: High School Diploma/GED
Experience: 1-3+ years of relevant experience
Key Responsibilities:
- Manages the documentation of the initial and/or reappointment application process at all Client facilities
- Performs admin duties and verifications within established policy and procedures and State and Joint Commission requirements
- Initiates sending reappointment packet to provider and processes appointments based on departmental assignments
- Completes required data entry into provider database
- Completes required verification of information for assigned credentials files
- Maintains accurate automated data files and ensures the complete and accurate maintenance of files in assigned areas
- Upon file completion , prepares credentials for Chiefs' signature.
- Prepares files for review at hospital specific Credentials Committee meetings.
- Tracks information through various committees
- Specialist will verify primary source for each application: Current/prior hospital affiliations; professional references;
- Specialist will query the following sources; professional license, National Provider Bank (NPDB) , Office of the Inspector General (OIG) , Health Claims Arbitration Office (HCSAO), Board certifications sites , Malpractice insurance carriers
- Maintains comprehensive credentialing database and prepares reports from physician file.