Vacancy expired!
What Would You Do? The Specifics.Communicates to Optometrists the credentialing instructions and directs them to the on-line Credentialing Verification Organization and supplies the Doctors all the necessary information and documentation needed to complete the on-line credentialing process. Provides support to Optometrists as well as Credentialing Verification Organization to ensure that credentialing is completed in a timely manner.Reviews Optometrists applications and composes credentialing instructions based on the data provided and data necessary to meet the National Committee for Quality Assurance (NCQA) credentialing guidelines and requirements.Rosters and adds new Optometrists into the Council for Affordable Quality Healthcare ProView (CAQH) system. This system is for doctors to self-report professional and practice information to payers, large provider groups and health systems.Works with Managed Care plans during annual file audits.Submits all completed credentialing files to NVI's Medical Director for approval, attends all Credentialing Committee meetings and protects the confidentiality of all items discussed.Updates, maintains, and checks for accuracy of the credentialing information in ProfTrax database, an internal database that tracks NVI Doctors information that relates to the credentialing process.Respond to requests from management/staff/providers/outside entities related to credentialing.Constantly monitors for sanctions against licenses, negative NPDB reports, documents with upcoming expiration dates (medical licenses, insurance, attestations etc.), upcoming re-credentialing dates, doctor transfers, patient complaints, and doctor terminations. Takes the appropriate action to protect patients and doctors privacy while ensuring that National Vision's credentialing requirements are met at all times.Maintains on-line file management system (GRM) for doctors.