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

Required Qualifications:

  • 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

direct link: https://westmedgroup.wd5.myworkdayjobs.com/en-US/WMG_Careers/job/NY-Rye-Brook-800-Westchester-Avenue/Credentialing-Associate-Assistant---Temp_Req-2020-2053