Job Description

Imperial Health

This position is:

Full Time

Position Location:

Lake Charles, LA

JOB DESCRIPTION

Job Title:

Credentialing Specialist

JOB SUMMARY:

The Credentialing Specialist maintains pertinent credentialing information for all providers to meet the credentials, standards and requirements of hospitals, entities, affiliations and healthcare networks.

ESSENTIAL FUNCTIONS:

• 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 in 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.

EXPERIENCE:

• Minimum of two (2) years of business office/administrative experience in a medical office/facility setting.

Or

• Minimum of three (3) years of advanced clerical experience in a professional office setting.
• Prior credentialing experience preferred.

EDUCATION REQUIRED:

• Minimum high school diploma or equivalent with experience as listed above.

SKILLS REQUIRED:

• Communication Skills – Strong communication skills and have personal professional appearance.
• Computer Skills – To perform this job successfully, an individual should be able to learn and use multiple computer software programs including Microsoft Word and Excel.
• Must possess excellent discretionary judgment and good organizational skills.

ABILITIES:

• Must be able to work independently with minimal supervision.
• Must be able to work with sensitive information in a professional and confidential manner.
• Must be able to communicate effectively in written and verbal form, answer frequent telephone calls.
• Must be able to relay information accurately in telephone conversations, messages, email, and other forms of commination.
• Must be able to work as a team player.
• Must be able to work flexible hours.
• Must be able to multi-task. Frequent interruptions require being able to handle a fast-paced work environment.
• Must be service oriented.
• Ability to exercise initiative.
• Deals effectively with all races, nationalities, cultures, disabilities, ages and genders.
• Ability to meet deadlines.

PHYSICAL/MENTAL DEMANDS:

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. Requires continuous standing, sitting, frequent walking, bending, and stooping. May require lifting up to 100 pounds.