Data Entry / Credentials Coordinator

  • location: Bedford, MA
  • type: Contract
  • salary: $20 - $24 per hour
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job description

Data Entry / Credentials Coordinator

job summary:
As a Credentialing Coordinator, you would be responsible for all aspects of the medical credentialing and recredentialing processes for all providers who are currently contracted or wish to be contracted.

To do this, you would maintain up-to-date data for each provider in the credentialing databases and verify, research, and evaluate credentialing data from the online systems. In addition, you would ensure timely verifications of licenses and certifications. Finally, you would coordinate the records and ensure complete and accurate provider credentialing records would then be reviewed by the Credentials Committee.

JOB ROLES AND RESPONSIBILITIES:

1. Performs queries in credentialing systems to assess the accuracy of credentials verifications

2. Reviews reports and provider applications against credentialing criteria

3. Reviews issues/problems with practitioner files and determines the appropriate course of action.

4. Researches and verifies postgraduate training for non-board certified providers via mail, internet, phone or fax. Evaluates postgraduate training for non-board certified providers against criteria

5. Evaluates postgraduate training for non-board certified providers against criteria

6. Documents and updates provider systems with resolution and/or status of provider issues

7. Prepares files for Credentials Committee review

8. Contacts provider offices and institutions to obtain additional information via phone, fax, internet and mail

9. Participates on special projects as needed

10. Performs all other duties and responsibilities deemed necessary.

11. Collaborate, coordinate, and communicate across disciplines and departments.

12. Ensure compliance with HIPAA regulations and requirements.

13. Demonstrate commitment to the Company's core values.

14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:

The incumbent works under general supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through experience to complete job responsibilities. Work involves support tasks with low to moderate complexity with more complex issues referred to higher levels.

Requirements

JOB REQUIREMENTS (Education, Experience, and Training):

* High School Diploma; Associates Degree or better preferred

* 2-3 years experience with database functions (maintenance and manipulation of data)

* Required licensures, professional certifications, and/or Board certifications as applicable

* Communication (written, verbal and listening) and problem solving skills

* Service oriented, flexible and ability to work under pressure

* Ability to work independently, effectively and well in both individual and team environments

* Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Microsoft Word and Excel, etc.

 
location: Bedford, Massachusetts
job type: Contract
salary: $20 - 24 per hour
work hours: 9am to 5pm
education: Associates
 
responsibilities:
JOB ROLES AND RESPONSIBILITIES:

1. Performs queries in credentialing systems to assess the accuracy of credentials verifications

2. Reviews reports and provider applications against credentialing criteria

3. Reviews issues/problems with practitioner files and determines the appropriate course of action.

4. Researches and verifies postgraduate training for non-board certified providers via mail, internet, phone or fax. Evaluates postgraduate training for non-board certified providers against criteria

5. Evaluates postgraduate training for non-board certified providers against criteria

6. Documents and updates provider systems with resolution and/or status of provider issues

7. Prepares files for Credentials Committee review

8. Contacts provider offices and institutions to obtain additional information via phone, fax, internet and mail

9. Participates on special projects as needed

10. Performs all other duties and responsibilities deemed necessary.

11. Collaborate, coordinate, and communicate across disciplines and departments.

12. Ensure compliance with HIPAA regulations and requirements.

13. Demonstrate commitment to the Company's core values.

14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:

The incumbent works under general supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through experience to complete job responsibilities. Work involves support tasks with low to moderate complexity with more complex issues referred to higher levels.

 
qualifications:
JOB REQUIREMENTS (Education, Experience, and Training):

* High School Diploma; Associates Degree or better preferred

* 2-3 years experience with database functions (maintenance and manipulation of data)

* Required licensures, professional certifications, and/or Board certifications as applicable

* Communication (written, verbal and listening) and problem solving skills

* Service oriented, flexible and ability to work under pressure

* Ability to work independently, effectively and well in both individual and team environments

* Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Microsoft Word and Excel, etc.

 
skills: JOB REQUIREMENTS (Education, Experience, and Training):

* High School Diploma; Associates Degree or better preferred

* 2-3 years experience with database functions (maintenance and manipulation of data)

* Required licensures, professional certifications, and/or Board certifications as applicable

* Communication (written, verbal and listening) and problem solving skills

* Service oriented, flexible and ability to work under pressure

* Ability to work independently, effectively and well in both individual and team environments

* Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Microsoft Word and Excel, etc.


Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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