Our mission at Progenity is simple: to help healthcare providers and patients prepare for life. We provide the most advanced molecular technology and the highest levels of service to guide patient care at critical life stages. We continually seek people with the motivation and skills to advance our mission.
The Senior Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical providers. The Credentialing Specialist is responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities. They will maintain up-to-date data for each provider in credentialing databases and online systems and will ensure timely renewal of licenses and certifications.
RESPONSIBILITIES
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Completes provider credentialing and re-credentialing applications for all commercial and government payors; monitor applications and follows-up as needed.
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Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
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Maintains corporate provider contract files.
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Maintains knowledge of current health plan and agency requirements for credentialing providers.
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Sets up and maintains provider information in online credentialing databases and system.
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Tracks license and certification expirations for all providers to ensure timely renewals.
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Ensures practice addresses are current with health plans, agencies and other entities.
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Audits health plan directories for current and accurate provider information.
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Serves as the “go-to” person for all day to day credentialing questions.
This list of duties and responsibilities is not all inclusive and may be expanded to include other duties and responsibilities, as deemed necessary.
REQUIREMENTS
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4+ years of previous credentialing experience required.
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Advanced knowledge of licensing, accrediting, CMS, and third party payer requirements.
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Proficient in working with Microsoft Office, specifically MS Excel.
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Strong oral and written communication skills.
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Must be able to handle a wide work variety and work in a fast-paced environment.
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Must be a detail-oriented, organized, self-starter, and have an ability to prioritize workload.
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Ability to analyze and interpret data and solve practical problems.
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Must be a self-starter and can work with little supervision.