Credentialing Specialist

  • location: Tampa, FL
  • type: Contract
  • salary: $17.50 per hour
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job description

Credentialing Specialist

job summary:
Operations\Credentialing

Provider Facility and Ancillary credentialing to include all aspects of new applicant credentialing re-credentialing; ongoing maintenance of provider credentials; online verifications; administrative support of credentialing functions.

ESSENTIAL FUNCTIONS

Review new applications and supporting documents in a virtual environment and apply policy and criteria required for credentialing processing

Perform all required primary source verifications

Contact hospitals licensing agencies malpractice carriers and medical schools to obtain credentialing verifications

Maintain and update credentialing database records

Review malpractice history. regulatory and disciplinary action reports issued by state and federal agencies invoking appropriate processes as defined in policies and procedures

Review the CAQH system and download applications or supplemental documents as appropriate. Maintain electronic provider files

Perform outreach to providers and facilities via phone calls and fax/email correspondence

Demonstrate knowledge of credentialing regulatory and accreditation requirements (NCQA. CMS. Medicaid. etc.)

MINIMUM QUALIFICATIONS

A High School or GED Required State the minimum required for the job

Experience Level Experience Details Required/Preferred

1+ year of experience in a hospital provider or managed care setting Required

2+ years of experience in a customer service or healthcare related position required

Other Certified provider credentialing specialist or directly related or equivalent work experience Preferred

Demonstrated written communication skills Intermediate

Demonstrated interpersonal/verbal communication skills

Ability to work as part of a team Intermediate

Ability to effectively present information and respond to questions from peers and management Intermediate

Other Knowledge of credentialing software sufficient to develop appropriate reports on all aspects of credentialing Intermediate

 
location: Tampa, Florida
job type: Contract
work hours: 9 to 5
education: High School
experience: 2 Years
 
responsibilities:
Operations\Credentialing

Provider Facility and Ancillary credentialing to include all aspects of new applicant credentialing re-credentialing; ongoing maintenance of provider credentials; online verifications; administrative support of credentialing functions.

ESSENTIAL FUNCTIONS

Review new applications and supporting documents in a virtual environment and apply policy and criteria required for credentialing processing

Perform all required primary source verifications

Contact hospitals licensing agencies malpractice carriers and medical schools to obtain credentialing verifications

Maintain and update credentialing database records

Review malpractice history. regulatory and disciplinary action reports issued by state and federal agencies invoking appropriate processes as defined in policies and procedures

Review the CAQH system and download applications or supplemental documents as appropriate. Maintain electronic provider files

Perform outreach to providers and facilities via phone calls and fax/email correspondence

Demonstrate knowledge of credentialing regulatory and accreditation requirements (NCQA. CMS. Medicaid. etc.)

MINIMUM QUALIFICATIONS

A High School or GED Required State the minimum required for the job

Experience Level Experience Details Required/Preferred

1+ year of experience in a hospital provider or managed care setting Required

2+ years of experience in a customer service or healthcare related position required

Other Certified provider credentialing specialist or directly related or equivalent work experience Preferred

Demonstrated written communication skills Intermediate

Demonstrated interpersonal/verbal communication skills

Ability to work as part of a team Intermediate

Ability to effectively present information and respond to questions from peers and management Intermediate

Other Knowledge of credentialing software sufficient to develop appropriate reports on all aspects of credentialing Intermediate

 
qualifications:
Operations\Credentialing

Provider Facility and Ancillary credentialing to include all aspects of new applicant credentialing re-credentialing; ongoing maintenance of provider credentials; online verifications; administrative support of credentialing functions.

ESSENTIAL FUNCTIONS

Review new applications and supporting documents in a virtual environment and apply policy and criteria required for credentialing processing

Perform all required primary source verifications

Contact hospitals licensing agencies malpractice carriers and medical schools to obtain credentialing verifications

Maintain and update credentialing database records

Review malpractice history. regulatory and disciplinary action reports issued by state and federal agencies invoking appropriate processes as defined in policies and procedures

Review the CAQH system and download applications or supplemental documents as appropriate. Maintain electronic provider files

Perform outreach to providers and facilities via phone calls and fax/email correspondence

Demonstrate knowledge of credentialing regulatory and accreditation requirements (NCQA. CMS. Medicaid. etc.)

MINIMUM QUALIFICATIONS

A High School or GED Required State the minimum required for the job

Experience Level Experience Details Required/Preferred

1+ year of experience in a hospital provider or managed care setting Required

2+ years of experience in a customer service or healthcare related position required

Other Certified provider credentialing specialist or directly related or equivalent work experience Preferred

Demonstrated written communication skills Intermediate

Demonstrated interpersonal/verbal communication skills

Ability to work as part of a team Intermediate

Ability to effectively present information and respond to questions from peers and management Intermediate

Other Knowledge of credentialing software sufficient to develop appropriate reports on all aspects of credentialing Intermediate

 
skills: MS Office
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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