Responsible for credentialing activities as it relates to initial credentialing, re-credentialing, and credentials modification. Tracking of issues associated with activities necessary to maintain and document ongoing compliance with CPC policy. Will be expected to assist with other tasks/projects as requested. Compliance with HCA policy and procedure, Federal and State regulatory and accrediting agencies is required.
DUTIES INCLUDE BUT ARE NOT LIMITED TO
Receive requests for applications
• Compile application and send to practitioner
• Responsible for intake and tracking of all applications and correspondence and maintaining documentation as requested
• Assist in the credentialing process by data entry of information into credentialing system for initial, updated, add on applications and maintenance processes
Accurately perform a variety of administrative duties such as: placing calls, processing incoming mail, processing facsimile verifications, scanning, sending written inquires, filing, copying, and other duties as needed
• Review for completeness of information, identify deficiencies
• Pursue incomplete information
• Process and maintain credentialing and recredentialing in accordance with CPC policy and procedure, Joint Commission standards, State and Federal Regulatory regulations
This will include but not limited to the following verifications:
National Practitioner Data Bank OIG/GSA for Medicare/Medicaid exemption
DEA Verification Licensure
• Prepare credentialing and recredentialing applications for process review
• Assure timeliness of process completion
• Assure confidentiality of data
• Ensure that all credentials files are current and complete pursuant to expiration date of medical licenses, board certification, professional-liability insurance coverage, DEA and other pertinent information, per CPC policy
• Maintain high quality, timely and accurate credentialing processes of medical and allied healthcare professionals per CPC policy
• Advise Credentialing Coordinator of questionable information received and any issues identified during the processes
• Compliance with HCA policy and procedure, Federal and State regulatory and accrediting agencies as required
Associate degree or an equivalent combination of education and experience preferred.
At least 1 year previous office experience including data entry, typing, and basic computer usage and proficient keyboard and PC skills preferred.
• Previous Credentialing experience preferred. Must have basic knowledge of the Credentialing process and standards.
• Typing speed 50 words per minute.
• Completion of post Cactus training testing of 90% or greater.
• Understanding of professional telephone etiquette.
• Able to work with minimal supervision and works well in both individual and group environment.
- NAMSS certified as CPCS preferred
HCA Inc - 18 months ago