Credentialing Coordinator

MBMS is seeking a self-motivated, organized, Credentialing Coordinator to be responsible for coordinating, monitoring and maintaining the payer enrollment and re-credentialing/revalidation process for our physician groups.

Duties and Responsibilities:

• 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

• Ability to analyze, interpret and draw inferences from research findings and prepare reports, documentation generation.

• Ability to manage confidential information