Credentialing Specialist

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

Credentialing Specialist

job summary:
Description:

Credentialing Specialist

JOB SUMMARY

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

Key Duties and Responsibilities

  • Review new applications and supporting documents in a virtual environment and apply policy and criteria required for credentialing processing.
  • Perform all required primary source verification.
  • Contact hospitals, licensing agencies. malpractice carriers, and medical schools to obtain credentialing verification.
  • 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.).
  • Perform other duties as assigned.
Additional Position Responsibilities

MINIMUM QUALIFICATIONS

  • A High School or GED Required
Work Experience

  • 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
Skills ---- State the minimum required for the job ---- Skill Sets Other Skills Proficiency

  • Demonstrated written communication skills Intermediate
  • Demonstrated interpersonal/verbal communication skills Intermediate
  • Ability to work as part of a team
  • Ability to effectively present information and respond to questions from peers and management
  • Other Knowledge of credentialing software sufficient to develop appropriate reports on all aspects of credentialing
Technology ---- List technical skills associated with the job ---- Technology Other Technology Proficiency Required/Preferred

  • Microsoft Word
  • Microsoft Excel
  • Microsoft Outlook
 
location: Tampa, Florida
job type: Contract
work hours: 8 to 5
education: High School
experience: 1 Years
 
responsibilities:
Description:

Credentialing Specialist

JOB SUMMARY

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

Key Duties and Responsibilities

  • Review new applications and supporting documents in a virtual environment and apply policy and criteria required for credentialing processing.
  • Perform all required primary source verification.
  • Contact hospitals, licensing agencies. malpractice carriers, and medical schools to obtain credentialing verification.
  • 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.).
  • Perform other duties as assigned.
Additional Position Responsibilities

MINIMUM QUALIFICATIONS

  • A High School or GED Required
Work Experience

  • 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
Skills ---- State the minimum required for the job ---- Skill Sets Other Skills Proficiency

  • Demonstrated written communication skills Intermediate
  • Demonstrated interpersonal/verbal communication skills Intermediate
  • Ability to work as part of a team
  • Ability to effectively present information and respond to questions from peers and management
  • Other Knowledge of credentialing software sufficient to develop appropriate reports on all aspects of credentialing
Technology ---- List technical skills associated with the job ---- Technology Other Technology Proficiency Required/Preferred

  • Microsoft Word
  • Microsoft Excel
  • Microsoft Outlook
 
qualifications:
Description:

Credentialing Specialist

JOB SUMMARY

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

Key Duties and Responsibilities

  • Review new applications and supporting documents in a virtual environment and apply policy and criteria required for credentialing processing.
  • Perform all required primary source verification.
  • Contact hospitals, licensing agencies. malpractice carriers, and medical schools to obtain credentialing verification.
  • 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.).
  • Perform other duties as assigned.
Additional Position Responsibilities

MINIMUM QUALIFICATIONS

  • A High School or GED Required
Work Experience

  • 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
Skills ---- State the minimum required for the job ---- Skill Sets Other Skills Proficiency

  • Demonstrated written communication skills Intermediate
  • Demonstrated interpersonal/verbal communication skills Intermediate
  • Ability to work as part of a team
  • Ability to effectively present information and respond to questions from peers and management
  • Other Knowledge of credentialing software sufficient to develop appropriate reports on all aspects of credentialing
Technology ---- List technical skills associated with the job ---- Technology Other Technology Proficiency Required/Preferred

  • Microsoft Word
  • Microsoft Excel
  • Microsoft Outlook
 
skills: Healthcare Law
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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