Credentialing Clerk

REPORTS TO: Credentialing Specialist / Director of Billing

FLSA STATUS: Non-Exempt

Entry-level position responsible for supporting the Credentialing Specialist with administrative tracking tasks related to provider credentialing and re-credentialing. The Credentialing Clerk assists with follow-up communications, documentation tracking, data entry, and record maintenance to ensure timely processing of provider applications, renewals, and updates. This role requires strong organization, attention to detail, and professional communication with internal teams and external payers.

• High School Diploma Required
• Bilingual English/Spanish required, must be able to read, write, and speak English.
• Basic knowledge of healthcare terminology and payer processes preferred.
• Basic computer knowledge; MS Word and MS Excel, internet, document with Electronic Health Records and/or authorization system with minimal typing/spelling errors, send e-faxes and email

• Strong organizational and follow-up skills.
• Excellent communication and telephone etiquette.
• Ability to manage multiple tasks and deadlines simultaneously.
• High attention to detail and accuracy.
• Ability to work independently with minimal supervision.
• Ability to maintain confidentiality of provider and patient information.
• Dependable, professional, and courteous demeanor.
• Ability to follow policies, procedures, and compliance requirements.

SUPERVISORY RESPONSIBILITIES:

N/A

• Assist Credentialing Specialist with follow-up calls and emails to insurance carriers and hospitals regarding application and re-appointment status.
• Track credentialing and re-credentialing applications and update internal tracking logs and spreadsheets.
• Monitor payer portals and credentialing systems for status updates and notifications.
• Request missing documentation from providers and internal departments.
• Scan, upload, and organize credentialing documents into electronic provider files.
• Assist with updating CAQH, NPI, PECOS, NPPES, Availity, and other payer portals as directed.
• Assist with provider demographic updates, address changes, and affiliation changes.
• Help prepare provider packets and credentialing submissions.
• Assist with tracking license, DEA, malpractice, and certification expiration dates.
• Maintain organized electronic and paper credentialing records.
• Communicate credentialing updates to internal departments as directed.
• Assist with process improvement initiatives within the credentialing workflow.
• Perform other related duties as assigned.

• Criminal Background Check

Employee Health Insurance is covered at 100%. We also offer Dental, Vision, Life, and 401k Benefits.