Westmed Medical Group is currently hiring for a 3 month temporary Credentialing Associate Assistant position.
The Credentialing Associate is responsible for the credentialing and re-credentialing process for providers within the Westchester Medical Group. Responsible to ensure all provider information is current and updated in the credentialing software.
Essential Functions and Job Responsibilities:
- Responsible for the credentialing and re-credentialing process and follow up with insurance carriers.
- Gathers all pertinent credentials from the provider and required by insurance carrier. Attaches to the credentialing application and sends application to insurance carrier for processing.
- Completes all necessary paperwork for re-credentialing
- Completes WMG internal credentialing process for all providers.
- Knowledgeable of NCQA and WMG credentialing guidelines, policies and procedures.
- Completes hospital appointments and reappointment applications. Follows up with medical staff office to ensure timely processing of application.
- Tracks all applications to ensure timeliness return from providers.
- Completes applications for Connecticut license and controlled substance.
- Completes worker’s compensation forms and follows through to ensure numbers are received.
- Completes CAQH forms and is proficient in the credentialing software.
- Maps new forms into credentialing software and downloads provider data.
- Responsible to maintaining accurate provider information in credentialing software. Ensures all information is current.
- Responsible to tracking provider license, DEA, CDS, boards etc to ensure they are renewed before expiration date
- Completes monthly spreadsheets for delegated insurance carriers.
- Reviews and completes spreadsheets as requested by insurance carriers.
- Maintains outlook with insurance provider numbers and other information as requested
- Scans all provider information, credentials and insurance into scanning software.
- Develop and maintain relationships with insurance carriers and hospital medical office staff.
- Adheres to all WMG Compliance Program Policies and Procedures including all regulatory financial and OSHA requirements. Participates in and contribute to help achieve a total compliance program.
- Manages assigned projects as directed. Performs other duties as requested
- High School graduate.
- 1-2 years credentialing experience preferred.
- Excellent computer skills.
- Excellent communication and organizational skills.
- Good interpersonal skills; ability to communicate with providers and office managers.
- Ability to work as a team member.
- Flexibility to respond to changing demands and environment.
- Ability to plan, prioritize and complete delegated demands.
Can apply through website: www. Westmedgroup.com or