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Woundlocal

Credentialing Specialist

Woundlocal, Austin, Texas, us, 78716

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Under general supervision, the credentialing specialist is responsible for assuring the proper credentialing and privileging of physicians and mid-level providers. This position is responsible for the initial credentialing, re‑credentialing and ongoing monitoring of sanctions and exclusions process for practitioners. This position is also responsible for meeting daily/weekly production goals and maintaining a high level of confidentiality for provider information.

Responsibilities

Guide provider through credentialing and re‑credentialing process and ensure the completion of required documentation for IndieMD TX

Work with provider to prepare and submit Medicare & Medicaid applications to enrollment office

Prepare all credentialing applications, develop and provide documentation that are not supplied by the provider, address any additional information or corrections requested

Verify and track the proper credentialing and re‑credentialing of physicians and mid‑level providers within IndieMD TX

Receive credentialing application and enter data into credentialing system

Work with provider to maintain and ensure compliance for all licensures and appointments with state and governmental agencies and certifications for each provider, generate monthly report of expiring credentials

Ensure ongoing monitoring of performance between credentialing cycles, generate performance review documentation, share with department for completion, and notify external entities when a provider has been suspended, if necessary

Notify providers and departments of credentialing status and result, email notice to department and provider, ensure credentialing system is updated with final credentialing result

Track and ensure the completion of required continuing medical education courses/workshops; provide documentation to outside entities according to requirements

Perform all other duties as assigned

Requirements

Three (3) years administrative experience, preferably in the hospital or clinical field, is required

Ability to effectively serve the customer’s needs with strong attention to detail and ensuring accuracy

Ability to work independently under limited supervision

Strong multitasking and organizational skills

Exhibits accuracy and thoroughness; monitors own work for quality

Strong organizational and time management skills

Proficiency in relevant software such as HSTREAM, PECOS, Availity, Cigna, UHC, and other payer portals

Strong verbal, written, and interpersonal communication skills

Benefits Why this job is AWESOME:

Great team! We spend a ton of time hiring and training the best people

Great pay! We pay very well

Great opportunities! We’re growing and we like to promote from within. If you’re a true rock star, the opportunities are limitless!

Seniority level Mid‑Senior level

Employment type Full‑time

Job function Other

Industry IT Services and IT Consulting

Austin, TX

Base pay range: $25.00/yr - $30.00/yr

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