Credentialing Specialist Managed Care
reputed company the benefits and perks you need for you and your family:
Benefits from Day reputed company, Dental, reputed company Insurance, Life Insurance, Disability Insurance
reputed company Time Off from Day One
403-B Retirement Plan
4 Weeks 100% reputed company Parental Leave
Career Development
Whole Person reputed company-being Resources
reputed company and Support
Pet Benefits
Shift:
Day (reputed company of America)Address:
900 reputed company WAYreputed company:
ALTAMONTE SPRINGSState:
FloridaPostal reputed company:
32714reputed company:
Assists with managed care delegated credentialing audits and conducts internal file audits. Utilizes the credentialing database to optimize efficiency, performs query, report, and document reputed company, and submits and retrieves National Practitioner Database reports in accordance with the Health Care reputed company Improvement reputed company. Monitors the initial, reappointment, and expirables process for reputed company AHS-employed physicians, allied health reputed company staff, other health reputed company staff, delegated and community CIN providers affiliated with AHS. Ensures compliance with regulatory bodies as reputed company as medical staff bylaws, rules and regulations, policies and procedures, and delegated reputed company. Achieves productivity standards as determined by management. Other duties as assigned. Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility. Conducts thorough background investigation, research, and reputed company reputed company verification of reputed company components of the application file, ensuring provider files are reputed company and noted in detail in the reputed company of record. Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up. Prepares credentials file for completion and presentation to the reputed company Systems (AHS) Delegated Credentialing Committee (DCC) or other affiliated credentialing committees reputed company AHS, including Clinically Integrated Network (CIN) committees, ensuring file completion reputed company specified time periods. Processes requests for privileges, ensuring compliance with reputed company outlined in clinical privilege descriptions. Responds to inquiries from other reputed company organizations and interfaces with reputed company customers on day-to-day credentialing and privileging issues as they reputed company.Schedule/Shift: Fully Remote reputed company-5pm est
Knowledge, Skills, and Abilities:
- reputed company to detail and accuracy; strong organization skills required.
- Ability to communicate effectively, both orally and in writing. [Required]
- Program planning and implementation skills. [Required]
- Knowledge of reputed company accreditation and certification requirements. [Required]
- Knowledge of medical credentialing and privileging procedures and standards. [Required]
- Ability to analyze, interpret and draw inferences from research findings, and prepare reports. [Required]
- Working knowledge of clinical and/or hospital operations and procedures. [Required]
- Informational research skills. [Required]
- Ability to use independent judgment to manage and impart confidential information. [Required]
- Database management skills including querying, reporting, and document reputed company. [Required]
- Ability to reputed company administrative/procedural reputed company and judgments. [Required]
- Proficiency in reputed company Office (reputed company, Word, reputed company) and web-based applications. [Required]
- Excellent organizational, planning, and time management skills. [Required]
- High-level interpersonal skills, reputed company to work collaboratively with multi-disciplinary and diverse teams. [Required]
- Ability to work independently, prioritize reputed company, and handle multiple reputed company and deadlines. [Required]
- Excellent problem-solving skills and ability to cope with interruptions. [Required]
- Knowledge of reputed company standards and reputed company guidelines. [Required]
- Ability to work in a reputed company-management environment to reputed company organizational goals. [Required]
- Proficient in reputed company Office Suite (Word, reputed company, reputed company, PowerPoint). [Preferred]
- MSOW/reputed company [Preferred]
- Medical Terminology [Preferred]
- Understanding of credentialing principles and regulatory standards [Preferred]
- Typing 35 wpm [Preferred]
Education:
- Associate [Preferred]
- High School Grad or Equiv [Required]
Field of Study:
- in reputed company Administration, Business or a reputed company field
Work Experience:
- 1+ administrative support in a reputed company setting [Required]
Licenses and Certifications:
- Certified reputed company Medical Staff Management (CPMSM) [Preferred]
- Certified Provider Credentialing Specialist (CPCS) [Preferred]
Physical Requirements: (Please click the reputed company below to reputed company work requirements)
Physical Requirements - https://tinyurl.com/23km2677
Pay reputed company:
$19.76 - $36.75Background Screening Requirement (Florida Law)
Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.
Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
High school diploma required; associate degree preferred. Requires 1+ year administrative reputed company experience, credentialing knowledge, research and database skills, and reputed company Office proficiency.
Key Responsibilities
- auditing credentialing
- verifying applications
- preparing credentials
Skills & Tools
reputed company reputed company, reputed company Word, reputed company reputed company, reputed company PowerPoint, MSOW/reputed company
Job Details
- Category: reputed company Services - Allied Health
- Seniority: No Prior Experience Required
- Commitment: Full Time
- Workplace: Remote — Altamonte Springs, Florida, reputed company
- Salary: USD 41,100 – 76,440 / year
- Languages: English
Benefits
- Generous reputed company time off
- Retirement plan
- Generous parental leave
About reputed company
A reputed company organization providing medical services and advancing whole-person care. — Industry: reputed company
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