Job Description

Innovative Hematology Job Opportunity

At Innovative Hematology (IHI), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families.

The Credentialing Specialist is responsible for credentialing, re-credentialing and privileging of all applicable medical staff. Also responsible for enrolling providers in all applicable public and private payer organizations.

The Opportunity

• Perform all aspects of the credentialing, re-credentialing and privileging process of applicable medical staff.
• Maintain CAQH, PECOS, and NPI registry for all IHTC providers as applicable.
• Create NPDB and AMA reports for each new provider upon hire and annually.
• Maintain copies of current state licenses, CSR and DEA certificates, malpractice coverage and any other required credentialing documents.
• Track license and certification expirations for all providers to ensure timely renewals.
• Coordinate with Payer Relations Manager to ensure all applicable providers are correctly attached to all existing and new contracts.
• Ensure provider demographics are kept updated with all payers.
• Audit health plan directories for current and accurate provider information.
• Maintain knowledge of current health plan and facility requirements for credentialing providers.
• Produce CME reports for all MD's six times per year and upon request.
• Maintain CME credits for each credentialed provider.
• Communicate with Providers via phone, email, face-to-face as needed to obtain information or provide education/follow-up related to credentialing process.
• Maintain confidentiality of provider information.

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