Provider Application Processing Specialist

Under the supervision of the Manager of Network Operations, the Provider Application Processing Specialist is responsible for coordinating the credentialing functions for the client.

The Application Processing Specialist coordinates all written communication to physicians, hospitals and ancillary providers to assure all credentialing information is complete for presentation to the Corporate Credentialing Department.

Performs a variety of secretarial, administrative, and clerical duties for Provider Network Operations.

Responsibility

• Responsible for submitting credentialing packet information to physicians, hospitals and ancillary providers when participation in the provider network is requested.

• Submits provider information to delegated credentialing organizations for credentialing data elements.

• Assembles provider credentialing materials received for submission to corporate credentialing department.

• Follows up with Provider Contracting representatives on outstanding items necessary for credentialing.

• Forwards provider information to all required corporate departments.

• Communicates openly with Provider Contracting staff and the Credentialing department.

• Maintains strict confidentiality

• Performs other related duties and projects as assigned.

• Adheres to client’s policies and procedures.

• Supports and carries out the client’s Mission & Values.

• Attends required training on an annual basis.

• High school graduate or equivalent – Required

• Previous Credentialing Experience – Highly Desired

• Experience in Managed Care or the Health Care environment – Highly Desired

• Microsoft Word & Microsoft Excel – Highly Desired

Thanks

Warm Regards

Kavita

732 - 662 - 5619