Credentialing Clerk

This position is responsible for the clerical functions that are essential in the credentialing process for providers, the maintenance of provider credentialing files, electronically and on paper. Complies with the HS1 Credentialing Program Description which meets all accreditation, federal/state/U.S. Commonwealth regulations and contracted clients requirements.

Essential Functions & Responsibilities

  • Organizing and maintaining credentialing files within the file room.
  • Downloading reports from various internet sites.ie. primary source verifications
  • Regularly and on-going monitoring of the expired credentials report.
  • Communicate regularly via fax, phone, email to providers, offices and facilities as necessary to obtain current credentialing information.
  • Ensures integrity of updated credentialing information data entered into company systems and/or databases.
  • Maintain a strict level of confidentiality for all matters pertaining to provider credentials.
  • Adheres to all company Compliance, Fraud/Waste/Abuse HIPAA policies, procedures and mandatory training.
  • Abillty to safely and successfully perform essential job functions consistent with the ADA, FMLA, and other federal, state, and local standards, including meeting qualitative and/or quantitative productivity standards.
  • Ability to come to work and work the regular schedule and shift for the position.
  • Compliance with all personnel policies and procedures.
  • Perform additional duties and related essential duties as assigned.

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Education and/or Experience

  • High school diploma or general education degree (GED). College experience preferred.

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