This position is:
Lake Charles, LA
Job Title: Credentialing Specialist
Essential Function: The Credentialing Specialist maintains pertinent credentialing information for all providers to meet the credentials, standards and requirements of hospitals, entities, affiliations and healthcare networks.
- Maintains provider credentialing files in compliance with regulatory standards. Ensures the timely and accurate submission of data to ensure deadlines are met.
- Initiation and Maintenance of Provider licensure, certifications, vital records and insurance coverage
- Initiation and Maintenance of Facility Affiliations
- Initiation, Maintenance and compliance of CAQH/Proview Database
- Initiation and Maintenance of Network Affiliations
- Maintains current knowledge of regulatory requirements and standards with regard to credentialing.
- Acts as liaison between the affiliations and providers regarding credentialing and re-credentialing activities.
- Coordinates the receipt and review of completed provider applications.
- Answers, researches, resolves and documents calls involving a wide range of credentialing issues utilizing multiple information systems.
- All other clerical and administrative duties as assigned.
Qualifications: Must be able to work independently with minimal supervision. Must possess excellent discretionary judgment and good organizational skills as well as excellent verbal and written communication skills. Must be able to work with sensitive information in a professional and confidential manner. Must be able to relay information accurately in telephone conversations, messages, email, and other forms of communication. Must have working knowledge of MS Word and Excel.
KNOWLEDGE, SKILLS & ABILITIES:
- Must possess strong organizational and communication skills
- Able to meet deadlines
- Work well under pressure
- Ability to promote teamwork
Minimum high school diploma or equivalent with experience as listed below.
- Minimum of 2 years of Business Office/Administrative experience in a medical office/facility setting or
- Minimum of (3) years of advanced clerical experience in a professional office setting
ENVIRONMENTAL/WORKING CONDITIONS: Office setting. Frequent telephone calls and other interruptions, which requires being able to handle a fast-paced work environment during entire time at work. Must be able to prioritize multiple projects. Must maintain strict confidentiality and exercise professionalism when interacting with staff, managers, supervisors, physicians, external customers, etc.
PHYSICAL/MENTAL DEMANDS: requires continuous standing, sitting, frequent walking, bending, and stooping. May require lifting 50 to 100 pounds. Exposure to possible Hazardous Materials/conditions and infectious diseases.