Job Summary:
The Credentialing Specialist -Provider Enrollment position acts as a liaison between providers, revenue cycle and practice operations making sure that all providers are set up correctly with payers. The Credentialing Specialist – Provider Enrollment position is responsible for providing administrative support for the process of payer enrollment credentialing for the medical staff at Westchester Medical Center Advanced Physician Services. Primary responsibility of this position is ensuring that all physicians and allied health professionals are payer enrolled and set up accurately with contracted payers. Work is performed in compliance with detailed requirements, guidelines, and deadlines of Centers for Medicare & Medicaid Services, National Committee for Quality Assurance (NCQA) in collaboration with WMCHealth Network Medical Staff Offices, accrediting organizations, and regulatory agencies. Does related work as required.
Responsibilities:
Experience:
Five years of experience where the primary function of the position was payor enrollment credentialing.
Education:
High school or equivalency diploma, required
Licenses / Certifications:
Other:
Knowledge of medical staff credentialing processes, procedures and resources; knowledge of requirements of various organizations which affect the credentialing process such as CMS, NCQA, New York State Education Department, and New York State Department of Health; good knowledge of the requirements of Westchester Medical Center By Laws and policies regarding credentialing and privileging standards for the various clinical departments and sections; good knowledge of medical terminology; ability to assemble and organize data; ability to determine priorities and meet deadlines; ability to effectively use computer applications such as spreadsheets, word processing, calendar, e-mail and database software in performing work assignments; ability to communicate effectively both orally and in writing; ability to establish and maintain effective working relationships with professional medical, technical, managerial, clerical and non-skilled personnel; attention to detail; sound and mature judgment; flexibility.
About Us:
NorthEast Provider Solutions Inc.
Benefits:
We offer a comprehensive compensation and benefits package that includes:
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