Job Description

QUALIFICATIONS

• Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors, and the public and be capable of establishing good working relationships with both internal and external customers.
• Some knowledge of insurance billing and hospital credentialing is a plus.
• Knowledge of the credentialing process is a plus but not required
• Knowledge of credentialing timelines and regulations is a plus but not required.
• Minimum of three to four years of experience in healthcare.
• High school diploma/GED or equivalent working knowledge preferred.

ESSENTIAL FUNCTIONS

• Reviews and Re-Attest all provider's CAQH profiles.
• Maintain billing insurance grid, provider insurance grid, and each physician’s spreadsheet up to date on current insurance changes.
• Has knowledge of Employee Handbook content along with established policies and procedures.
• Relies on instructions and pre-established guidelines to perform the functions of the job.
• Assists the Credentialing Supervisor and Credentialing Specialist in their job responsibilities/duties when necessary.

The Credentialing Assistant is responsible for reviewing the Payer Credentialing status for all new providers, maintain all rosters, updating CAQH provider profiles, and more.

Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.

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