Credentialing Specialist

360care • Louisville, KY

8d

About The Position

The person in this role is responsible for performing background checks, organizing credentialing documentation, gathering information in relation to on-boarding and working closely with healthcare providers and facilities.

Requirements

• High school graduate required.
• 1+ years of office administration experience in a medical office.
• 2+ years of credentialing experience.
• Requires flexibility to move within different departments, workflows and tasks as needed.
• Strong knowledge of and skill in the use of a PC and other office equipment (copier, scanner, fax, etc.).
• Strong Windows, Excel, Word and internet applications knowledge.
• Ability to interact effectively with a variety of people including physicians and facilities.
• Provide high level of customer service for both internal and external candidates.
• Strong written and verbal communication skills.
• Must be legally authorized to work in the United States.
• Any offer of employment is conditional upon the successful completion of a background investigation and drug screen.

Nice To Haves

• Medicare and Medicaid a plus.
• SharePoint experience is a plus.
• One App software preferable but not required.
• Experience with CAQH documentation and functionality is a plus.
• Ideal candidate must be highly self-motivated with the ability to implement and manage cross-functional activities.
• Strong organization and excellent follow-up skills.

Responsibilities

• Perform background checks and organizing of credentialing documents for new and existing healthcare providers.
• Gather provider credentials, drug screens and any other items related to the onboarding process.
• Complete insurance enrollment for providers in multiple specialties.
• Provide credentialing information to nursing facilities.
• Track expiring credentialing documents, obtain from provider and distribute as needed.
• Maintain One App program to track applications and expirations.
• Actively supports and complies with all components of the compliance program, including, but not limited to, completion of training and reporting of suspected violations of law and Company policy.
• Maintains confidentiality of all information; abides with HIPAA and PHI guidelines at all times.
• Reacts positively to change and performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED