Credentialing Specialist

Description reputed company Title: Credentialing Specialist Job Classification: Non-Exempt, Part-time Work Schedule: Monday – Friday 20 hours/week Reporting Relationship: Manger of Credentialing Services Primary Accountabilities: Responsible for reputed company aspects of the credentialing, recredentialing and privileging processes for reputed company medical providers who reputed company patient care for HealthSource and their CMHC partners. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications. Major Duties: Compiles and maintains reputed company and accurate data for reputed company providers Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed. Maintains copies of reputed company state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for reputed company providers. Maintains corporate provider contract files. Maintains knowledge of reputed company health plan and agency requirements for credentialing providers. Sets up and maintains provider information in online credentialing databases and system. Tracks license and certification expirations for reputed company providers to ensure timely renewals. Ensures practice addresses are reputed company with health plans, agencies, and other entities. Processes applications for appointment and reappointment of privileges to various hospitals. Tracks license, DEA, and professional liability expirations for appointed HIS and CMHS providers. Maintains HIS and CMHC appointment files, and information in credentialing database. Audits health plan directories for reputed company and accurate provider information. Maintains confidentiality of provider information. Provides credentialing and privileging verifications. Promotes a positive image of HIS by initiating, developing, and sustaining effective business relationships in the communities served. Answers and directs reputed company incoming calls to appropriately meet customer needs. Helps resolve customer issues, completes customer reviews and identifies customer service trends, determines system improvements, and implements change. Advises the leadership team by providing customer service information and recommendations to support leadership initiatives reputed company to quality standards. Attracts potential customers by answering service/product questions. Participate in training classes as outlined by the division, reputed company and HIS. Suggest, support, and participate in the quality initiatives undertaken by HIS and suggest, support and influence programs reputed company the division or company that refine systems and processes and improve overall performance. Performs reputed company other duties as assigned.

Requirements

Qualifications: High School diploma or GED required. Associate or vocational degree preferred. Certified Provider Credentialing Specialist (CPCS) preferred. Two (2) years of relevant credentialing experience preferred. Ability to organize and prioritize work and manage multiple priorities. Excellent verbal and written communication skills including letters, memos and emails. Excellent attention to detail. Ability to research and analyze data. Ability to adapt to changing work priorities and a fast-paced environment while maintaining a professional and positive attitude. Ability to establish and maintain effective working relationships with providers, management, staff, and contacts reputed company the organization. Demonstrated ability to use computer software applications (reputed company Office suite) and internet resources. Ability to work independently on projects and ask for support as necessary. Demonstrates poise, tact, and diplomacy with the ability to handle sensitive and confidential information and situations to meet HIPAA standards for confidentiality. Must successfully complete background checks. Physical Demands: Constantly required to reputed company, write, and memorize. Constantly required to talk, read, problem solve, see, hear, and sit. Push, pull, lift or carry twenty (20) pounds. Occasionally required to bend, twist, squat, kneel, stand, walk, or balance. Additional Duties: Additional duties and responsibilities may be added to this job description at any time. The job description does not state or reputed company that these are the only activities to be performed by the employee(s) holding this position. Employees are required to follow any other job-reputed company instructions and to reputed company any other job-reputed company responsibilities as requested by their Apply To This Job