Job Description Job:Credentialing Specialist EEOC:Administrative SupportStatus:Non-exemptDepartment:Finance (This job has the flexibility to work from home and work from 32 hours up to 40 in a given week.)Position Overview: Under limited supervision, manages and monitors processes and procedures that support the credentialing, re-credentialing, expirables data management, and delegated credentialing contract processes. Oversees all of the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies. Responsibilities:Serves as company liaison with 3rd party payorsManages update to date information regarding fee schedulesManages and updates credentialing & clinic licensure policies and protocolsEnsures reports on credentialing status of providers is up to date and accurateDefines and implements processes to ensure credentialing is completed and up to date in a timely mannerManages process of negotiating new insurance contractsEnsures all clinic information is accurate within 3rd party payor directoryDrives and implement seamless protocols for gathering credentialing data from health care providersQualifications:High school education requiredMedical practice experience, surgical practice experience preferredExcellent verbal and written communication skillsEfficiency and organizational skillsAdministrative skillsComputer literacy and adaptive to new technologyPHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, and environmental conditions may vary depending on assigned work area and work tasks.
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...seeking a detail-oriented and organized Remote Experience Planning Coordinator to assist with coordinating plans, services, schedules, and... ...the planning process. The role may include supporting travel-related plans, scheduled experiences, reservations, and other...