CREDENTIALING/ENROLLMENT SPECIALIST - FULL TIME at WATSON CLINIC LLP

Lakeland, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

13 Jan, 26

Salary

0.0

Posted On

15 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Provider Enrollment, Critical Thinking, Attention to Detail, Organizational Skills, Time Management, Communication Skills, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Adobe, Internet Research, Healthcare Compliance, Data Analysis, Regulatory Research, Process Improvement

Industry

Medical Practices

Description

Description Summary/Objective Responsible for the day to day coordination and completion of the credentialing and provider enrollment for medical providers. Essential Functions Processes and coordinates the provider initial and reapplications of credentialing and privileging, and provider enrollment applications. Ensures credentialing files are completed and accurately verified along with all required documentations prior to review by the Credentialing Manager in preparation for Credentials Committee. Monitoring, collecting, updating provider expirables- license, dea, cpr, appointment, etc Assist with and Coordinate applications with affiliated facilities. Assists in the preparation of appointment/reappointment letters and delineation of privileges for practitioners. Liason in resolution of enrollment issues, internal and external. Prepares rosters and reports as requested by departments and payers. Directory maintenance Assists with Facility enrollment, new and maintenance. Assists in the maintenance of all practitioners’ credentials files, assuring that all mandatory documents are current and on file. Cross trains on department items to cover as needed. Other department duties, projects Work Environment& Physical Demands Must be able to remain in a stationary position 50% of the time. The person in this position needs to occasionally move about the inside of the office to access file cabinets, office machinery, etc. Constantly operates a computer and other office productivity machinery, such as a calculator, copier and computer printer Travel No travel is expected for this position other than occasional travel to corporate sites regarding employee relations issues. Requirements Required Education and Experience High school graduate. Two-year degree from an accredited college or university is preferred, but not required. CPCS or CPSMS Certification preferred. Reporting and analytic background a plus. Preferred Education and Experience Critical thinking and analysis of provider data; Knowledge of Contracted plans; ability to research applicable regulations and statues; high degree of accuracy and attention to detail; ability to assist in process innovation and improvement; understanding of clinic entity structures; excellent organizational, time management and communications skills; ability to use and engage in internet research and other technology skills. Experience in credentialing, healthcare provider enrollment or contracting/compliance preferred. CPCS certification to be obtained when eligibility requirements have been met (minimum 3 years credentialing experience). Additional Eligibility Qualifications Proficiency in Microsoft Word, Excel, PowerPoint and Adobe. Familiarity with websites - Provider Enumeration System (NPPES) Officer of inspector General database (OIG), Identity & Access Management System (I&A), Provider Enrollment, Chain, and Ownership System (PECOS) and others.

Responsibilities

The Credentialing/Enrollment Specialist is responsible for coordinating and completing the credentialing and provider enrollment for medical providers. This includes processing applications, monitoring provider expirables, and assisting with facility enrollment.