Credentialing specialist vs medical support assistant

Differences between credentialing specialist and medical support assistant 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 support assistant example responsibilities.

• Provide pharmaceutical services to Medicaid recipients through manage care organizations and fee-for-service programs.
• Coordinate front and back office tasks such as checking in and checking out patients, triage, and insurance verification.
• Assist with enrolling patients into the TRICARE online website so patients can access appointments remotely from any web enable device.
• Analyze patients' financial information to recommend suitable programs and lifesaving aid for both veterans and eligible family members.
• Review and audit payroll reports.
• Apply knowledge of coding systems, including ICD-9-CM and CPT.
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