AB7 SOLUTIONS jobs - Credentialing and Enrollment Specialist

·         Maintain current and accurate data for all providers. 

·         Complete provider credentialing and credentialing applications; monitors applications and follows-up as needed.

·         Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.

·         Maintains corporate provider contract files. 

·         Maintains knowledge of current health plan and agency requirements for credentialing providers.

·         Sets up and maintains provider information in online credentialing databases and systems.

·         Tracks license and certification expirations for all providers to ensure timely renewals.

·         Sets up and maintains provider information in online credentialing databases and systems. 

·         Tracks license and certification expirations for all providers to ensure timely renewals.

·         Ensures practice addresses are current with health plans, agencies, and other entities. 

·         Processes applications for appointment and reappointment of privileges to The Doctors Clinic (ASC).

·         Processes applications for appointment and reappointment of privileges to The Doctors Clinic (ASC). 

·         Maintains ASC appointment files, and information in the credentialing database. 

·         Store the documents centrally on our secure document management systems 

·         Obtain the enrolment number from the payer and communicate the state of the application to the physician 

·         Obtain the enrolment number from the payer and communicate the state of the application to the physician , 

·         Periodic update of the document library for credentialing purposes.