Seeking a full-time credentialing specialist to join our large pediatric multi-specialty practice. Flexible work hours available with the possibility of Hybrid schedule after 3 months.
SUMMARY: Coordinates all functions related to the credentialing and recredentialing of health care providers with both hospitals and payers and maintains provider credentialing files.
DUTIES AND RESPONSIBILITIES:
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Receives and processes all initial credentialing and recredentialing applications.
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Collects all pertinent information from the provider, provider’s malpractice insurer, National Practitioner Data Bank (NPDB) and other sources as deemed appropriate.
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Ensures that credentialing and recredentialing of providers occurs on a timely basis in accordance with industry and company standards and criteria.
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Maintains accurate and complete records of each application’s status.
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Enters all provider information into database.
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Prepares all documents to be reviewed by hospital Credentialing Committees
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Maintains all credentialing and recredentialing timelines and schedules.
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Maintains strict level of confidentiality on all matters pertaining to provider.
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Maintains well-organized provider files that are easily reviewed by credentialing committee, outside review bodies, and others.
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Processes approval, denial, or termination letters.
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Performs other related duties as assigned by management.
QUALIFICATIONS:
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Bachelors degree, or associates degree with equivalent experience and training
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2+ years experience in provider credentialing strongly preferred
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Commitment to excellence and high standards
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Excellent written and oral communication skills
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Ability to manage priorities and workflow
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Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm
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Ability to work independently and as a member of various teams and committees
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Proficient on Microsoft Word and Excel. Experience using credentialing software strongly preferred.
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Acute attention to detail
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Demonstrated ability to plan and organize projects
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Able to work collaboratively with multiple health professionals in a busy and complex environment using tact, diplomacy, and discipline.
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Ability to communicate professionally and effectively in person, on the phone, electronically, or through other means to individuals and groups.
JOB TYPE / WORK SCHEDULE:
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This is a full-time position, in-office position - Hybrid after 3 months
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Standard office hours, Monday – Friday
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Bilingual Preferred
Competitive pay and a full benefits package, including 401(k), health, dental, vision, life, and disability insurance.
