Essential Job Duties

Complete provider initial and re-credentialing applications and submit with supporting documentation to all requested payers, hospitals, and ASCs
Monitor application progress and follow up with payers until “in network” status has been confirmed/received
Revalidation and recredentialing requests issued by government payers
Maintain copies of providers’ required credentialing documents (current state licenses, DEA certificates, malpractice coverage, etc.)
Track all state/medical licenses, DEA, and Board Certification/Recertification expirations; assist providers with renewals to ensure they are completed in a timely manner.
Track CME and send quarterly updates to providers.
Maintain Physician Extender (PE) Compliance and ensure that Audit Ready files remain up to date
Renew MACM applications yearly, track expenses for providers and renew memberships/subscriptions
Oversee malpractice claims and communicate with MACM, attorneys, and provider(s)
Manage provider data via online databases and systems such as CAQH, PECOS, NPPES, etc.
Responsible for PrimeSource Verification of State license, DEA, and Board Certification
Assist physicians with ABOS WLA each year
Manage Resident Rotations for BOS providers who participate in Memorial Hospital’s Family Medicine program
Create, manage, and maintain emergency department on-call schedule for physicians using prior year’s call schedule as reference
Primary liaison for call schedule changes between Bienville physicians, hospital staff, and Bienville’s answering service to ensure 24/7 coverage
Assist with administrative assistant duties and other duties as assigned/needed

Additional Requirements:

Excellent verbal and written communication skills
Must demonstrate a high degree of trust and confidentiality
Must get along well with others and have a team-oriented work ethic
Ability to work independently and assume assigned responsibilities
Ability to be flexible and function well in a fast-paced environment with multiple interruptions
Must be able to travel to all clinic locations and work overtime as needed

Position is Full Time, Non-exempt, Hourly

Work Hours: Monday - Friday 8am-5pm (Occasional after hours support if needed)

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Bienville Orthopaedic Specialists

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CREDENTIALING ASSOCIATE