Position Summary:
Processes credentialing and re-credentialing applications and Credentialing Vendor requests for OBHG health care providers.
I. Position Responsibilities: Essential
- Maintain credentialing information by reviewing, entering and following up on missing information
- Establish and maintain professional relationship with providers, insurance providers, client contacts and account service/credential personnel
- Submit and follow up on request for signatures in a timely manner
- Respond to credentialing request
- Contact and respond to request to/from hospitals and health payers for verification of provider's credentials, ensuring credentialing and licensing processes are completed timely
- Responsible for the processing and preparation of the applications for insurance payer participation with the ability to manage multiple facilities'/payers' enrollment requirements, which includes non-application requests that are indicated by OBHG staff and/or facility/payer
- Track credentialing application statuses
- Maintains providers/practitioner files including maintenance of the OBHG provider database, individual CAQH profiles and providers rosters by identifying who may need updating or re credentialing and process accordingly
- Maintains and updates CRM, Mail and Utility Logs for provider's licensure, board certifications and certificate of insurance
- Escalate non-responsiveness of MD to Supervisor with documentation of request
- Meet required turnaround times and accuracy rates
- Ensure all Protected Health Information is kept in a secure location at all times and maintain Compliance by communicating credentialing request, status and issues to the Corporate Compliance Officer
- Participate in the credentialing committee as necessary
- Perform other duties as assigned by Payer Enrollment Manager and/or Management
II. Essential Skills/Credentials/Experience/Education
- Knowledge of clerical principles and strong telephone etiquette
- Strong organizational skills and attention to detail
- A minimum of a High School Diploma or equivalent is required; some college or equivalent experience is preferred
III. Preferred Skills/Credentials/Experience/Education
- Two-three years of clerical experience
- Strong computer skills, proficient in Word, Excel & Access
- Preferred understanding of medical terminology
- CPCS credentialing preferred
IV. Mental and Physical Demands (per ADA guidelines)
Physical Demands:
- Sitting for long periods of Occupation requires this activity more than 66% of the time (2.6+ hrs/day)
Travel Demands:
- May require travel to offsite meeting events
Hourly Compensation Range: $22.00 - $24.00
What We Offer – The Good Stuff:
- A mission based company with an amazing company culture.
- Paid time off & holidays so you can spend time with the people you love.
- Medical, dental, and vision insurance for you and your loved ones.
- Health Savings Account (with employer contribution) or Flexible Spending Account options.
- Employer Paid Basic Life and AD&D Insurance.
- Employer Paid Short- and Long-Term Disability.
- Optional Short Term Disability Buy-up plan.
- 401(k) Savings Plan, with ROTH option.
- Legal Plan.
- Identity Theft Services.
- Mental health support and resources.
- Employee Referral program – join our team, bring your friends, and get paid.