Credentialing Coordinator

Job Details Level: Experienced

Job Location:

Reading - Wyomissing, PA 19610

Education Level: High School Job Shift: Day

• Maintains confidentiality of provider information
• Assists in department training and client onboarding for MBMS
• Completes provider payer enrollment and re-credentialing/revalidation applications.
• Monitors provider/organization payer enrollment applications and follows-up as required.
• Maintains primary source verification of all providers current Medical Licenses, DEA’s, and board certifications.
• Maintains copies of Physician Group current licenses, ACR Certification and all required documentation for enrollment purposes.
• Maintains copies of the providers current malpractice insurance and all educational documentation.
• Maintains provider contract files by requesting contracts and working with clients to ensure they agree to all terms and conditions.
• Maintains Tickets in the Credentialing Department Ticketing System.
• Collaborate with internal departments, such as CS (Client Service) to ensure seamless integration and coordination of provider enrollment activities and billing.
• Maintaining credential stream software with provider demographics and all assigned physician groups.
• Processing Enrollments and utilizing workflows via Credential Stream for provider enrollment.

• High School diploma or equivalent
• CPMSM or Certified Provider Credential Specialist certificate preferred or minimum two years’ experience.
• Above average knowledge of basic medical billing and insurance carriers
• Demonstrated written and oral communications skills
• Proficient with Microsoft Excel