Credentialing specialist vs surgery scheduler

Differences between credentialing specialist and surgery scheduler 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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Surgery scheduler example responsibilities.

• Manage medical records and patient information within HIPPA guidelines
• Manage patient pre-op responsibilities, and generate all necessary paperwork.
• Request financial screening services for patients with limit Medicaid packages, as well as the uninsured.
• Provide patients with information that explain hospital admission policies, time of admission and HIPPA privacy guidelines.
• Execute administrative tasks such as ordering supplies and working with CPT and DX codes relate to accurate patient billing.
• Maintain HIPAA and confidentiality standards.
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