Credentialing Coordinator

MBMS; Reading, Wyomissing (Berks County, Berks County); On-site; USD 42,000 - 54,000; Full time

Job summary

MBMS in Reading, PA is seeking an Experienced Credentialing Specialist to support provider enrollment and credentialing processes. You will maintain confidentiality, assist in onboarding, and complete payer enrollment/re-credentialing applications.

You will monitor enrollment activities, verify licenses and certifications, maintain documentation for enrollment, and manage provider contracts. Collaboration with CS and other departments is essential for seamless operations.

Qualifications

• Requires high school diploma or equivalent.
• CPMSM or Certified Provider Credential Specialist certificate preferred or minimum two years’ experience.
• Above average knowledge of basic medical billing and insurance carriers.
• Demonstrated written and oral communications skills.
• Proficient with Microsoft Excel.

Responsibilities

• Maintains confidentiality of provider information.
• Assists in department training and client onboarding for MBMS.
• Completes provider payer enrollment and re-credentialing/revalidation applications.
• Monitors provider/organization payer enrollment applications and follows-up as required.
• Maintains primary source verification of all providers licenses, DEA’s, and board certifications.
• Maintains copies of physician group licenses, ACR certification and enrollment documentation.
• Maintains copies of malpractice insurance and educational documentation.
• Maintains provider contract files and coordinates with clients on terms.
• Maintains tickets in Credentialing Department Ticketing System.
• Collaborates with internal departments to ensure seamless enrollment and billing coordination.
• Maintains credential stream software with provider demographics and assigned physician groups.
• Processes enrollments and uses Credential Stream workflows for provider enrollment.

Skills

Provider enrollment

Credentialing workflow

MS Excel

Communication skills

Education

CPMSM or Certified Provider Credential Specialist (CCPS) certificate

Tools

Credential Stream

Microsoft Excel

Job description

Job DetailsLevel: ExperiencedJob Location: Reading - Wyomissing, PA 19610Education Level: High SchoolJob Shift: Day

Duties and Responsibilities:

• Maintains confidentiality of provider information
• Assists in department training and client onboarding for MBMS
• Completes provider payer enrollment and re-credentialing/revalidation applications.
• Monitors provider/organization payer enrollment applications and follows-up as required.
• Maintains primary source verification of all providers current Medical Licenses, DEA’s, and board certifications.
• Maintains copies of Physician Group current licenses, ACR Certification and all required documentation for enrollment purposes.
• Maintains copies of the providers current malpractice insurance and all educational documentation.
• Maintains provider contract files by requesting contracts and working with clients to ensure they agree to all terms and conditions.
• Maintains Tickets in the Credentialing Department Ticketing System.
• Collaborate with internal departments, such as CS (Client Service) to ensure seamless integration and coordination of provider enrollment activities and billing.
• Maintaining credential stream software with provider demographics and all assigned physician groups.
• Processing Enrollments and utilizing workflows via Credential Stream for provider enrollment.

Qualifications

• High School diploma or equivalent
• CPMSM or Certified Provider Credential Specialist certificate preferred or minimum two years’ experience.
• Above average knowledge of basic medical billing and insurance carriers
• Demonstrated written and oral communications skills
• Proficient with Microsoft Excel