Credentialing Administrator

Concentra•Addison, TX

10d•Onsite

About The Position

This role provides day-to-day support for the Contracting and Credentialing teams. Key responsibilities include launching team workflows in the IntelliCred database, managing and tracking DOT and APC/ATC certifications and compliancy, handling facility credentialing for Group Health payers, tracking group health payer agreements for executive review, and allocating/submitting expenses for internal credentialing verification charges. The position requires strong administrative skills, attention to detail, and proficiency in Microsoft Office Suite, particularly Excel. The employee must be able to handle sensitive and confidential information in accordance with federal and state laws and company policies.

Requirements

High School Diploma or GED
A college degree in a related field or equivalent work experience.
At least 2 years of experience.
At least 2 years of administrative skills experience.
Moderate to advanced Excel skills.
Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility.
Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions.
Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism.
The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies.
Ability to accurately type.
Detail oriented and highly organized.
Microsoft Office Suite.
Excellent verbal and written communication skills.
Ability to utilize all proprietary Concentra software programs.
Ability to work independently within company guidelines and policies.
Ability to effectively present information and respond to questions from managers, clients, and customers.
Ability to speak effectively in one-on-one situations.
Ability to read and comprehend standardized instructions, short correspondence, and memos.
Ability to effectively present information in one-on-one situations to other employees, providers, and clients.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to apply commonsense understanding to carry-out instructions furnished in written, oral, or diagram form.
Basic understanding of office equipment (copier, scanner, fax, phone).

Responsibilities

Serve as support for maintaining and tracking DOT certifications for all physicians, nurse practitioners, and physician assistants.
Research/validate DOT certification and practice profiles via the National Registry of Certified Medical Examiners (NRCME) website.
Communicate notification of DOT certification and practice profile status to the field EAs and track for Concentra compliancy through the IntelliCred database.
Serve as support for maintaining and tracking all APC/ATC agreements for compliancy.
Submit written requests to field EAs for APC/ATC agreements for all new hire, annual/biennial renewals and supervising physician changes of Nurse Practitioners, Physician Assistants, and Athletic Trainers.
Track and monitor completion of APC agreement requests for compliancy through the IntelliCred database.
Facilitate, maintain, and track facility credentialing applications for Urgent Care, Physical Therapy, Primary Care, and Work Comp payers.
Complete simple to complex credentialing applications with supporting documents such as local, state, and federal licensures, CLIA certificates, center assessment, and services offered questionnaires.
Maintain and track credentialing activities in the IntelliCred database through various workflows.
Act as the primary liaison to secure needed facility licensures by working with the internal licensing department, clinical, and operational leaders.
Conduct internal audits such as facility rosters and various IntelliCred database validations to ensure data integrity.
Launch workflows in the IntelliCred system for Medicare, Group Health, and Quality Control and Administration teams for new hires, terms, location updates for clinician Medicare enrollment, external payer credentialing needs, APC Collaborative Agreements, and DOT certification compliancy.
Participate in acquisition activities for the department to include launching workflows for all teams, updating all internal facility rosters, and IntelliCred Group records.
Maintain all departmental administrative tasks such as office supplies, incoming/outgoing mail, Fed Ex, and department contact lists.
Create and maintain internal Facility Listings on shared drive and Groups/Locations in database to include facility demographics, NPIs, legal entity, TIN, Medicare PTAN, and billing information utilized by the department and for external Group Health payer needs.
Prepare various reports such as custom facility listings and provider rosters as requested for internal and external clients.
Track contracts for review and signature by executive leaders.
Maintain all Group Health payer contract files via electronic and hard-copy file system.
Reconcile Internal Credentialing verification charges, obtain receipts for each transaction, validate and allocate the correct billing string for biweekly submission through the Concur expense reporting system.