Credentialing Specialist at Harris Computer

Worldwide

<p>Daily tasks and responsibilities include, but not limited to:</p><ul><li>Provide support and assistance for new practice setup as needed.</li><li>Assist with the completing and submitting provider enrollment applications.</li><li>Track progress of outstanding applications and communicate with provider relations representatives for follow-up ensuring enrollment completion.</li><li>Maintain accurate and current information in the provider records in credentialing software database and in provider electronic folders.</li><li>Maintain credential files in an orderly and current manner.</li><li>Provide research and administrative support for special projects.</li><li>Ensure HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities.</li><li>Create new credentials electronic files, save provider’s credentials to that file according to Global Share Filing Structure Policy, create new Practice and Provider Data Sheets.</li><li>Provider Credentials:  Maintain current credentials i.e. medical licensure, DEA, COI’s, etc. and set Verity CredentialStream reminders for notification of future expiration dates; maintain Provider Data Sheets with current credentialing information; maintain the credentials spreadsheet for the emergency and urgent care practices.</li><li>CAQH Re-attestation:  Maintain CAQH re-attestation spreadsheet and re-attest as required updating any expired credentials.</li><li>Incoming E-mail, Faxes:  Respond to requests for renewed credentials, W-9s, etc.</li><li>Maintain Electronic Files:  Update provider files with current information, documentation.</li><li>Credentialing Software:  Document all daily activities in Verity CredentalStream and Teamwork.</li><li>Change of Information:  Submit to health plans change of information letters and W-9s regarding practice moves, adding locations, changing remit addresses.</li><li>Follow-up:  Make calls or send emails to health plans and/or medical facilities to check status of applications, change of information letters, or contracts.</li></ul><p> <br />Important Note: This Job Description is subject to any reasonable adjustment in accordance with the changing and developing needs of the position.</p><p></p><p>Qualifications and Requirements</p><ul><li>Preferably College Graduate or at least 2 years in College</li><li>Degrees and Courses related to Medical Field is a plus</li><li>Strong written and verbal communication skills</li><li>Ability to work effectively with minimal supervision</li><li>Ability to work with confidential information</li><li>Detail oriented</li><li>Proficient in the use of email</li><li>Highly motivated self-starter</li><li>Organized, able to set priorities and meet deadlines</li><li>Dependable and reliable</li><li>Team player being supportive of Department and Company goals and policies</li><li>Must be flexible with schedule</li><li>Previous call center experience related to Medical Accounts and Programs is a plus</li></ul>