Credentialing Specialist

PruittHealth • Norcross, GA

49d

About The Position

Responsible for submitting all credentialing and re-credentialing applications and attachments for all services and facilities within PruittHealth.

Requirements

• Ability to multi-task and handle consistent workflow
• Ability to think critically and work independently
• Attendance - must maintain timely, regular attendance.
• Communicates well with clients, vendors, fellow partners, visitors and family members providing warm and friendly greeting and an approachable attitude. Answers questions when appropriate in a professional manner.
• Develop and foster relationships
• Effective oral, written and telephone skills
• Excellent customer service and communication skills
• Initiative to follow-up on pending issues and organize and assign work
• Must be able to maintain confidentiality regarding company proprietary information
• Must have the ability to relate professionally and positively and work cooperatively with external partners and other employees at all levels
• Professional appearance. Dresses according to Company's Dress Code Policy
• Proficiency in MS Office Suite (Excel, PowerPoint, Word, Outlook, Teams, etc.)
• Work within scope of job requirements

Nice To Haves

• Minimum 2 years' experience in healthcare contract credentialing or equivalent

Responsibilities

• Review and process incoming and outgoing paperwork, including directory updates, provider credentialing applications, demographic changes of services and other related forms.
• Provide office, project management and data analysis support.
• Maintain a comprehensive database of all facilities and payers with updated information regarding credentialing and re-credentialing
• Maintain a file with updated copies of all documents required for credentialing of all PruittHealth services.
• Answers incoming telephone inquiries from PruittHealth entities and payers regarding contracts and credentialing issues.
• Work closely with all PruittHealth entities and educate on the requirements of credentialing and re-credentialing.
• Support the Payer Relations with reports and updates regarding participation status with all payers.
• Maintain corporate standard time frame for completion of credentialing applications.
• Perform special projects upon request
• Excellent Communication, Customer Service and Time Management Skills
• Handles any additional duties as assigned by Management
• Attends and participates in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification as required.
• Attends and participates in mandatory in-services.
• Complies with corporate compliance program.
• Performs other related duties as necessary and as directed by supervisor.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Nursing and Residential Care Facilities
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees