Credentialing specialist vs appointment coordinator

Differences between credentialing specialist and appointment coordinator duties and responsibilities

Credentialing specialist example responsibilities.

• Establish rapport with all PCP offices, hospital personnel, and manage care representatives.
• Manage and administer the programs CME accredit education programs/Conferences.
• Ensure enrollment and participation with all organization contract managed care plans and perform Medicaid/Medicare provider enrollment.
• Process and manage all requests and applications for CME certification and supervise activities relate to credentialing process.
• Perform spot claims audits to ensure CMS compliance with ICD-9, HCPCS, CPT, and other requirements.
• Maintain and track data for OPPE and FPPE according to hospital policy and regulatory requirements.
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Appointment coordinator example responsibilities.

• Manage check-in and registration process for all appointments including physician appointments and medical imaging.
• Schedule re-check appointment and MRI appointments.
• Make sure all HIPAA laws are adhere to.
• Schedule new patient, re-check and MRI counseling appointments.
• Access EMR to respond to clinic/patient request for medical information.
• Maintain confidentiality of all patient information per HIPAA guidelines.
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