Credentialing specialist vs medical office administrator

Differences between credentialing specialist and medical office administrator 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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Medical office administrator example responsibilities.

• Re-Evaluat & improve policy manual, develop standards for HIPPA, OSHA, manage care, billing and medical compliance.
• Facilitate client relationships and manage surgery schedules, financial consultations, follow up care and ongoing maintenance.
• Used knowledge of medical procedures and customer service, record medical histories and schedule patients for hospitalization and other procedures.
• Scan new information such as daily progress notes, physical exams, labs and diagnostic testing into EMR.
• Advise and counsel patient regarding food, fluid, medicine intake and restrictions prior to surgery including drop regime.
• Organize patient charts and loose reports, as well as paper work from daily operations for scanning into EMR system.
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