Credentialing Specialist

Full Time
Orlando, FL 32826
$17 - $19 an hour
Posted 10 days ago
Job description

Loyal Source Government Services is seeking a Credentialing Specialist to join our team in Denver, CO.


Pay:
$17-$19 per hour


ESSENTIAL FUNCTIONS AND BASIC DUTIES


Credentialing:

  • The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by our customers.


File completion to include, but not limited to:

§ Primary Source Verifications

§ Employment Verifications

§ Reference Verifications

  • Maintain all credentialing tracking logs for providers currently working on assignment or in between assignments.
  • Request and pursue obtaining copies of all required renewable credentials prior to their expiration.
  • Reminders will be sent to providers at 90, 60, and 30-day intervals and then weekly within the last 30 days prior to expiration.
  • If a renewable credential cannot be obtained prior to expiration, specialist will communicate the deficit to the appropriate Program/Account Manager so that appropriate action can take place.
  • Send copies of updated credentials to customers as directed, prior to expiration.


PERFORMANCE MEASUREMENTS

1. All required records are up-to-date, accurate, and in compliance with company policy.

2. Credentialing functions are conducted in accordance with established Company policies and legal requirements.

3. Clinicians are treated professionally and well informed of their status of credentialing file.

4. Good coordination and effective working relations exist with other departments. Assistance is provided as needed.

5. Management is well informed of area activities and of any significant problems.


QUALIFICATIONS


EDUCATION/CERTIFICATION:

Associate Degree or equivalent with Healthcare Admin experience.


REQUIRED KNOWLEDGE:

Basic understanding of healthcare terminology processes and strategies.


EXPERIENCE REQUIRED:

One year or more of administrative experience, preferably in healthcare.


SKILLS/ABILITIES:

Communicates and works well with others in a team environment.

Good customer service and public relations.

Knowledge of related computer applications including database entry.

Excellent phone skills.

Able to work well independently and in a team environment.

Attention to detail and solid organizational skills.


MENTAL ACTIVITIES AND REQUIREMENTS OF THIS POSITION


REASONING ABILITY:

Ability to apply common sense understanding to carry out detailed but uninvolved instructions and to deal with problems involving a few variables.


TECHNOLOGICAL ABILITY:

Competent in the use of MS Word and Excel.


INTENT AND FUNCTION OF JOB DESCRIPTIONS

Job descriptions assist organizations in ensuring that the hiring process is fairly administered and that qualified employees are selected. They are also essential to an effective appraisal system and related promotion, transfer, layoff, and termination decisions. Well-constructed job descriptions are an integral part of any effective compensation system.


All descriptions have been reviewed to ensure that only essential functions and basic duties have been included. Peripheral tasks, only incidentally related to each position, have been excluded. Requirements, skills, and abilities included have been determined to be the minimal standards required to successfully perform the positions. In no instance, however, should the duties, responsibilities, and requirements delineated be interpreted as all inclusive. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

In accordance with the Americans with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodations will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization.

Job descriptions are not intended as and do not create employment contracts. The organization maintains its status as an at-will employer. Employees can be terminated for any reason not prohibited by law.

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