Credentialing Assistant

Employment Type:

Full time

Shift:

Description:

The Credentialing Assistant serves as a resource to the organization for CMS (Centers for Medicare and Medicaid Services) and commercial payer enrollment processes by demonstrating expert knowledge of all applicable CMS and commercial payer rules and regulations. Primary responsibilities include accurate and timely processing of provider and supplier enrollment application along with file maintenance.

The Credentialing Assistant will be responsible for the following functions

• Demonstrate an in-depth understanding of CMS and commercial payer enrollment rules and regulations.

• Maintain current knowledge of CMS and commercial payer enrollment rules and regulations and serves as a resource across the organization.

• Work in collaboration with various departments and individuals through the organization in all phases of the provider enrollment and re-enrollment process to ensure accurate completion and timely submission of all contracted payer enrollment forms and notifications, including Medicare 855 forms.

• Responsible for requesting and maintaining all organization and individual NPI numbers.

• Provides support as needed to the Medical Staff Office to ensure accurate and timely submission of all delegated enrollment requests.

• Responsible to perform follow up with delegated payers to verify effective date information and confirm requests are processed accurately and timely.

• Demonstrate the ability to create and maintain a complex system of records, including but not limited to the enrollment tracking spreadsheet and NPI enumeration spreadsheet.

• Monitors status of pending enrollment submissions until approval notification/assigned billing number is received.

• Communicates approvals/billing number assignment information to billing office(s) in a timely manner to allow for optimal A/R and financial performance.

• Demonstrates self-motivation with the ability to work independently, effectively prioritize work based on operational and financial goals/impact and make appropriate decisions within the scope of the position.

• Participates effectively as a team member, specifically with the Physician Employment Services, CredentiaSource, Medical Staff Services, Payer Strategy, Facility, and Physician Billing Offices.

The Credentialing Assistant should have the following knowledge, skills, and abilities:

• High school graduate or equivalent required.

• Minimum of two (2) years of hospital or physician billing, physician practice or hospital business experience preferred.

• Two-year degree in business or related healthcare field preferred.

• Prior provider enrollment experience preferred.

• Demonstrates excellent communication skills and an ability to effectively prioritize work based on organizational and financial goals/impact.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran