Credentialing Specialists ensure that medical staff members’ of Cottage medical Group and Ambulatory network maintain current credentials with all insurance payers and licenses to work legally in their field or specialty. These specialists monitor upcoming renewal dates and work with medical staff to advise them of the required steps to maintain their credentials with insurance payers. They also review information on potential new employees to make sure all required licenses and credentials with insurance payers are current before hiring. 

QUALIFICATIONS 

All job qualifications listed indicate the minimum level necessary to perform this job proficiently. 

LEVEL OF EDUCATION 

Minimum: 

Preferred: Associate's or Bachelor's Degree 

CERTIFICATIONS, LICENSES, REGISTRATIONS 

Minimum: 

Preferred: Acheive a minimum of 30 credit awarded by NAMSS National Association Medical Staff Services in the first two years of employment. 

TECHNICAL REQUIREMENTS 

Minimum: Intermediate MS Word, Excel, Outlook, and PowerPoint skills. 

Preferred: Knowledge off billing regulations and requirements for both Government and Nongovernment payers. Knowledge of insurance plan policies and procedures for credentialing and enrollment. 

YEARS OF RELATED WORK EXPERIENCE 

Minimum: 1 years of credentialing experience working with government and commercial insurance payers. 

Preferred: 5-7 years of credentialing experience working with government and commercial payers and developed relationships with insurance payers; Reporting specific deadlines and areas for improvement. MD Staffing database proficiency. Medical billing office experience