Hospitalist coordinator vs credentialing specialist

Differences between hospitalist coordinator and credentialing specialist duties and responsibilities

Hospitalist coordinator example responsibilities.

• Manage inpatient transfers to rehabilitation and medical facilities, along with preparing and monitoring outpatient billings insurance verification and referrals.
• Benefit tracking includes vacation, sick time and CME reimbursement.
• Maintain Hospitalists schedule to ensure coverage, tracking PTO and CME requests.
• Coordinate, maintain and reconcile monthly tracking reports for billing, payroll and clinical hours.
• Develop follow-up program for high-risk and non-compliant patients.
• Collect verify, prepare, and submits Hospitalists payroll information
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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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