Credentialing Assistant (Cebu/CDO)

Daily tasks and responsibilities include, but not limited to: • Provide support and assistance for new practice setup as needed. • Assist with the completing and submitting provider enrollment applications. • Track progress of outstanding applications and communicate with provider relations representatives for follow-up ensuring enrollment completion. • Maintain accurate and current information in the provider records in credentialing software database and in provider electronic folders. • Maintain credential files in an orderly and current manner. • Provide research and administrative support for special projects. • Ensure HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities. • Create new credentials electronic files, save provider’s credentials to that file according to Global Share Filing Structure Policy, create new Practice and Provider Data Sheets. • Provider Credentials: Maintain current credentials i.e. medical licensure, DEA, COI’s, etc. and set Verity CredentialStream reminders for notification of future expiration dates; maintain Provider Data Sheets with current credentialing information; maintain the credentials spreadsheet for the emergency and urgent care practices. • CAQH Re-attestation: Maintain CAQH re-attestation spreadsheet and re-attest as required updating any expired credentials. • Incoming E-mail, Faxes: Respond to requests for renewed credentials, W-9s, etc. • Maintain Electronic Files: Update provider files with current information, documentation. • Credentialing Software: Document all daily activities in Verity CredentalStream and Teamwork. • Change of Information: Submit to health plans change of information letters and W-9s regarding practice moves, adding locations, changing remit addresses. • Follow-up: Make calls or send emails to health plans and/or medical facilities to check status of applications, change of information letters, or contracts. Important Note: This Job Description is subject to any reasonable adjustment in accordance with the changing and developing needs of the position. Qualifications and Requirements • Preferably College Graduate or at least 2 years in College • Degrees and Courses related to Medical Field is a plus • Strong written and verbal communication skills • Ability to work effectively with minimal supervision • Ability to work with confidential information • Detail oriented • Proficient in the use of email • Highly motivated self-starter • Organized, able to set priorities and meet deadlines • Dependable and reliable • Team player being supportive of Department and Company goals and policies • Must be flexible with schedule • Previous call center experience related to Medical Accounts and Programs is a plus