SUMMARY OF RESPONSIBILITY:

The Credentialing Specialist reports to the Credentialing Team Lead and is responsible for collecting and verifying sensitive provider data through confidential sources and maintains credentialing database.

Essential Functions:

• Complete complex credentialing forms accurately and complies requested information for packets.
• Enters and tracks information into databases.
• Communicate positively with customers and companies to maintain customer loyalty
• Organizes and maintains file system and files correspondence and other records.
• Reads and routes incoming mail. Locates and attaches appropriate file to correspondence to be answered by employer.
• Makes copies/scans correspondence or other printed materials
• Prepares outgoing mail and correspondence, including e-mail and faxes to meet department deadlines.
• Adheres to the policies and procedures of USM

QUALIFICATIONS AND COMPETENCIES:

• Exemplary attention to detail
• Ability to multi task and work independently

• Possess excellent computer and communication skills

 REQUIRED CREDENTIALS & TRAINING/EDUCATION

• Associate’s Degree or equivalent from a two-year college or technical school; or two to three years of related work experience and/or training or equivalent combination of education and experience
• Experience in Credentialing, Insurance or Insurance knowledge and background is a plus