JOB PURPOSE:

The Credentialing Specialist reports is responsible for timely and accurate credentialing and enrollment processes associated with government and/or commercial payers; ensuring compliance with regulatory standards department processes; maintaining accurate records within the licensing and credentialing database.  This position involves daily contact with both internal and external customers. 

Key Responsibilities:

Complete complex credentialing forms accurately and compile requested documentation for packet submission. Research and validate government requirements and regulations to prepare documentation to submit with Medicare and state Medicaid enrollment applications. Research, validate, and complete full cycle execution of all necessary business licenses including, but not limited to: City, County, State, Bedding and HME/ DME licenses and specific requirements. Maintain and monitor records database with all pertinent credentialing and business requirements, completely and timely. Meet all deadline submissions with companies, commercial payers, Medicare and state Medicaid agencies. Provide excellent customer service to all internal and external customers of the operations.   Organizes and maintains file system and files correspondence and other records. Makes copies/scans correspondence or other printed materials. Prepares outgoing mail and correspondence, including e-mail and faxes to meet department deadlines. Utilize the Numotion Leadership Principles to perform the job with integrity, compliance, and values consistent with Numotion’s mission. Adheres to the policies and procedures of Numotion.

Other Functions:

Perform related duties as required.

 The duties listed above are intended only as illustrative of the various types of work that may be performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar or a logical assignment to the position.