The Credentialing Clerk (CC) is responsible for all aspects of the credentialing, recredentialing processes for all providers who deliver client services. The CC is responsible for ensuring providers are credentialed, appointed, and approved with all payor sources and facilities. The CC will maintain up-to-date data for each provider in credentialing databases and online systems and ensure timely renewal of licenses and certifications.
- Compiles and maintains current and accurate data for all providers.
- Sets up and maintains provider information in online credentialing databases and systems.
- Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed.
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Works closely with the HR Coordinator to maintain copies of current state licenses, malpractice coverage, and any other required credentialing documents for all providers.
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Other duties as assigned.
The Credentialing Clerk must have a high school diploma, GED, or suitable equivalent and 2+ years of credentialing experience with healthcare professionals or other relevant experience.