Credentialing specialist vs scheduling specialist

Differences between credentialing specialist and scheduling specialist 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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Scheduling specialist example responsibilities.

• Manage clinic visit schedules, rehabilitation conferences, medical exams, trial appearances, depositions, etc.
• Treat all patients with compassion and dignity no matter what their socioeconomic status is.
• Job entail becoming familiar with medical insurance carriers, which include Medicaid and Medicare programs.
• Schedule patients for radiology procedures, including complicate scheduling for multiple exams in one patient visit.
• Register patients into EMR system, ensuring accuracy when updating patient information, demographics and insurance.
• Schedule outpatient appointment for radiology patients, verify insurance, obtain authorization from insurance companies for special procedures.
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