The credentialing assistant will be a skilled professional with expertise in insurance follow-up. This role entails conducting weekly follow-ups for all commercial insurances selected by the client, ensuring comprehensive documentation is provided, and collaborating closely with insurance providers to facilitate the completion of enrollment (achieving in-network enrollment status) with each follow-up, as well as current contract inquiries.
Tasks{{:}}
Locate correct insurances on ‘Cred To Do' spreadsheet, send inquiries for application and/or network status via phone call and/or email.
Maintain detailed status notes for each client based on the following status{{:}
} IF ENROLLMENT IS COMPLETE{{:
}} 1. call reference
/s 2. representative names and dates of ca
ll 3. provider/group IDs when applicab
le 4. provider effective date AND group effective date (these may diffe
r) 5. date when the welcome letter was mailed out (and confirm mailing addres
s) IF ENROLLMENT IS STILL PROCESSING{{
:}} 1. call referenc
e/s 2. representative names and dates of c
all 3. detailed status and next steps (ask "what stage is the application currently in and what is the next step? When is this expected to complet
e?")When the insurance enrollment completes, provide proper documentation to the credentialing t
eam Credentialing Health Check inquiries- call each insurance chosen to find out the following{
{:}} 1. Group Effective
date 2. Request copy of contract (to be sent via em
ail) 3. Request provider roster (showing all the providers who are linked to the group contr
act) 4. Group re-credentialing
date 5. Request assigned clinic representative (if applicable) and record their phone # and e
mail 6. Record group ID (when applica
ble) 7. Confirm servicing addre
The credentialing assistant will be a skilled professional with expertise in insurance follow-up. This role entails conducting weekly follow-ups for all commercial insurances selected by the client, ensuring comprehensive documentation is provided, and collaborating closely with insurance providers to facilitate the completion of enrollment (achieving in-network enrollment status) with each follow-up, as well as current contract inquiries.
Tasks{{:}}
Locate correct insurances on ‘Cred To Do' spreadsheet, send inquiries for application and/or network status via phone call and/or email.
Maintain detailed status notes for each client based on the following status{{:}
} IF ENROLLMENT IS COMPLETE{{:
}} 1. call reference
/s 2. representative names and dates of ca
ll 3. provider/group IDs when applicab
le 4. provider effective date AND group effective date (these may diffe
r) 5. date when the welcome letter was mailed out (and confirm mailing addres
s) IF ENROLLMENT IS STILL PROCESSING{{
:}} 1. call referenc
e/s 2. representative names and dates of c
all 3. detailed status and next steps (ask "what stage is the application currently in and what is the next step? When is this expected to complet
e?")When the insurance enrollment completes, provide proper documentation to the credentialing t
eam Credentialing Health Check inquiries- call each insurance chosen to find out the following{
{:}} 1. Group Effective
date 2. Request copy of contract (to be sent via em
ail) 3. Request provider roster (showing all the providers who are linked to the group contr
act) 4. Group re-credentialing
date 5. Request assigned clinic representative (if applicable) and record their phone # and e
mail 6. Record group ID (when applica
ble) 7. Confirm servicing addre