Credentialing Specialist at PruittHealthSanta Rosa

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Full Time

Start Date

Immediate

Expiry Date

03 Feb, 26

Salary

0.0

Posted On

05 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Re-Credentialing, Project Management, Data Analysis, Customer Service, Communication, Time Management, Confidentiality, MS Office Suite, Critical Thinking, Multi-Tasking, Relationship Building, Initiative, Professional Appearance, Organizational Skills

Industry

Hospitals and Health Care

Description

POSITION SUMMARY: Responsible for submitting all credentialing and re-credentialing applications and attachments for all services and facilities within PruittHealth. WORKING RELATIONSHIPS: Directly Reports to: Director of Managed Care Contracts ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES: • Review and process incoming and outgoing paperwork, including directory updates, provider credentialing applications, demographic changes of services and other related forms. • Provide office, project management and data analysis support. • Maintain a comprehensive database of all facilities and payers with updated information regarding credentialing and re-credentialing • Maintain a file with updated copies of all documents required for credentialing of all PruittHealth services. • Answers incoming telephone inquiries from PruittHealth entities and payers regarding contracts and credentialing issues. • Work closely with all PruittHealth entities and educate on the requirements of credentialing and re-credentialing. • Support the Payer Relations with reports and updates regarding participation status with all payers. • Maintain corporate standard time frame for completion of credentialing applications. • Perform special projects upon request • Excellent Communication, Customer Service and Time Management Skills • Handles any additional duties as assigned by Management ESSENTIAL SKILLS AND COMPETENCY: • Ability to multi-task and handle consistent workflow • Ability to think critically and work independently • Attendance – must maintain timely, regular attendance. • Communicates well with clients, vendors, fellow partners, visitors and family members providing warm and friendly greeting and an approachable attitude. Answers questions when appropriate in a professional manner. • Develop and foster relationships • Effective oral, written and telephone skills • Excellent customer service and communication skills • Initiative to follow-up on pending issues and organize and assign work • Must be able to maintain confidentiality regarding company proprietary information • Must have the ability to relate professionally and positively and work cooperatively with external partners and other employees at all levels • Professional appearance. Dresses according to Company’s Dress Code Policy • Proficiency in MS Office Suite (Excel, PowerPoint, Word, Outlook, Teams, etc.) • Work within scope of job requirements ESSENTIAL ADMINISTRATIVE FUNCTIONS: • Attends and participates in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification as required. • Attends and participates in mandatory in-services. • Complies with corporate compliance program. • Performs other related duties as necessary and as directed by supervisor. PREFERRED SKILLS AND EXPERIENCE: • Minimum 2 years’ experience in healthcare contract credentialing or equivalent Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference. We are eager to connect with you! Apply Now to get started at PruittHealth! As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

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Responsibilities

The Credentialing Specialist is responsible for submitting all credentialing and re-credentialing applications and attachments for all services and facilities within PruittHealth. This role involves reviewing and processing paperwork, maintaining databases, and providing support to PruittHealth entities regarding credentialing requirements.