Credentialing Specialist

NaphCare•Birmingham, AL

12d•Onsite

About The Position

NaphCare is hiring a Credentialing Specialist to join our team in Birmingham, AL. Work is 100% in-office. The Credentialing Specialist is responsible for assessing and verifying credentials; database management; credentialing regulatory requirements; peer review and on-going maintenance of providers.

Requirements

Bachelor’s degree preferred
NAMSS CPCS preferred
A minimum of 1-2 years’ provider credentialing experience
Understanding of credentialing concepts to include multistate licensing, AMA, and NPDB, database management, accreditation standards and compliance
Strong and proven Data Management experience required
Strong customer service skills
Highly organized and detail-oriented
Strong verbal and written communication
Ability to work effectively in a fast-paced, multi-scope, result-oriented environment
Ability to maintain confidentiality of all proprietary and/or confidential information
Integrity, professionalism and ability to adhere to a Code of Conduct and comply with all facility(s) correctional healthcare policies, procedures, and legal requirements
Must pass a drug screen and criminal background check

Responsibilities

Establishes and maintains positive and productive relationships with providers.
Educates providers and staff to ensure efficient and effective credentialing policies, procedures and standards.
Acts as liaison between correctional facilities, corporate and providers
Initial review and on-going maintenance of provider credentials to include collaborations.
Facilitate Peer Review Process.
In depth understanding and effective performance of the credentialing database.
Problem solving—the individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully
Interpersonal Skills—the individual maintains confidentiality, remains open to others’ ideas and exhibits willingness to try new things.
Oral communication—the individual speaks clearly and persuasively in positive or negative situations, demonstrates group presentation skills and conducts meetings.
Written Communication—the individual edits work for spelling and grammar, presents numerical data effectively and is able to read and interpret written information.
Planning/organizing—the individual prioritizes and plans work activities, uses time efficiently and develops realistic action plans, keeps leadership informed of work progress and barriers
Quality control—the individual demonstrates accuracy and thoroughness and monitors own work to ensure quality.
Adaptability—the individual adapts to changes in the work environment, manages competing demands and is able to deal with frequent change, delays or unexpected events.
Dependability—the individual is consistently at work and on time, follows instructions, responds to management direction and solicits feedback to improve performance.
Safety and security—the individual actively promotes and personally observes safety and security procedures, and uses equipment and materials properly.