Credentialing Assistant (Remote)
- 1) Assists credentialing staff as needed, i.e., intake and uploading of new credentialing documents, input of data into database, sending and receiving of application packets links, filing, etc.
- 2) Monitors, on an ongoing basis, all expirables, such as physician medical licenses, DEA certificates, Furnishing license, Fluoroscopy certificate, board certification and malpractice insurance, BLS, etc. to ensure that current documentation is present in credentials files, expiry dates are updated and in compliance with policies, comments are maintained in the database, Coordinators are kept informed, and appropriate follow-up and documentation is maintained. Other expirables may be included as per policy.
- 3) Supports ongoing monitoring activities for delegated credentialing and enrollment.
- 4) Answers departmental main phone line and refers calls to appropriate staff. Attempts to problem solve customer’s issue before forwarding on.
- 5) Processes medical staff verification requests from other health care entities and runs activity reports as needed.
- 6) Maintains departmental correspondence files.
- 7) Provides general clerical assistance as required by Director and assistant Director including special project requests, such as maintenance of the Hospital Staff, PA Students, and School of Medicine, MedHub Reports and Assistance, Stanford Risk Claims requests, WHW Clearance requests, and monitoring LPCH Ongoing Professional Practice Evaluation alerts.
- 8) Maintains confidentiality of documents and information.
- 9) Provides backup support for Medical Staff Assistant as needed.
- 10) Receive and distribute departmental mail.
- 11) Scan and upload images to credentialing database as appropriate.
- 12) Provide support to customers concerning paperless credentialing database.
- 13) Primary source for ordering and maintaining department office/computer supplies.
- 14) Maintains database tables in accordance with policy, such as Address Standardization and Updates – Office/Hospital/Insurance.
- 15) Ensures email and fax accounts are managed and up to date daily. This includes but is not limited to the following: MedStaff Account Monitoring (general questions), Provider Updates Account Monitoring, Find a Physician emails, MSSD Fax, Expirables, and personal email account. Reply to PreCheck emails.
- 16) Maintains the accounting for the department and ensures the information is kept up to date, follow up is handled appropriately, and staff notified of the status on an ongoing basis. Accounting may include but is not limited to balancing P-Card, maintaining balances on needed verification websites, application fees, late fees, dues and fees check deposits, credit card deposits, etc.
- 17) May establish a system of committee support for all assigned Medical Staff committees, ensuring appropriate clerical support, development of consistent formats, maintenance of committee materials, etc. Ensures that meeting minutes accurately reflect the discussion and action at meetings. Completes meeting minutes upon completion of meeting in a timely manner.
- 18) Has knowledge of Medicare, Medi-Cal, Medicaid, and CCS payor enrollment requirements.
- 19) Processes applications and other documents for completeness and complies with defined enrollment processes via the electronic system and any other method as defined within the department.
- 20) Verifies that requests for enrollment are appropriate based on set criteria.
- 21) Expected to analyze and problem solve while considering regulations, policies, procedures, and guidelines.
- 22) Closely monitors collection of all information. Reviews the quality of information received; tracks and acquires additional information in an organized fashion, when necessary, per established policies, procedures, guidelines, and regulations.
- 23) Initiates and/or completes or participates in enrollment expirables as outlined in policies, procedures, and guidelines. May initiate and/or complete for reverifications and deferral processes.
- 24) Proactively initiates and facilitates the Provider Enrollment process (new providers, provider changes, renewals, and locations), and identifies areas for improvements to the process.
- 25) Performs other related and incidental duties as needed or assigned.
- High school diploma, or GED. College degree preferred.
- Four (4) or more years of clerical, secretarial or office support work. Two (2) years of experience in healthcare setting (Physician practice, outpatient or clinic setting), health maintenance organization (HMO), or insurance company may meet the requirement depending on work performed)
- Ability to type minimum 65 wpm.
- Knowledge of computer applications and word processing required. (Knowledge of Microsoft Word and Excel preferred.)
- Excellent organizational, inter-personal, and communication skills (both oral and written) are essential, including the ability to prepare accurate, and timely reports, meeting minutes, policies, etc.
- Ability to interact with all levels of management and able to set priorities and manage multiple demands effectively.
- Ability to function independently with excellent judgment and minimal supervision as well as the ability to function in a team capacity.
- Ability to demonstrate discretion, confidentiality, tact, and the ability to deal with sensitive.
- None
- Seldom (please list each item under Comments).
- Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.
- Know Me: Anticipate my needs and status to deliver effective care
- Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
- Coordinate for Me: Own the complexity of my care through coordination
Recommended Jobs
Service Advisor
Come join our winning TEAM! Coyne Powersports in Banning!!! Southern California`s FASTEST growing Powersports dealer wants YOU!! We are looking for a full time Service Advisor with significant exp…
Sr. Change Management Specialist
Overview As a Sr. Change Management Specialist at Esri, you will play a key role in ensuring internal marketing projects achieve successful adoption and alignment with organizational goals. This role…
Senior PR & Communications Manager (Build-from-Scratch Role)
Senior PR & Communications Manager (Build-from-Scratch Role) Location: Hybrid – San Francisco, CA (2 days onsite; Monday–Thursday in-office collaboration rhythm) Compensation: $145,000 – …
Airline Operations Intern
Archer is an aerospace company based in San Jose, California building an all-electric vertical takeoff and landing aircraft with a mission to advance the benefits of sustainable air mobility. We are d…
Assistant Store Manager
Exciting Opportunities with dd's Discounts opening 2nd store in Vallejo! POSITION OVERVIEW: The Assistant Store Manager assists the Store Manager in managing and controlling the operations of …
Warehouse Associate
Company Overview Come join a winning Team! Since 1970 Plastic Express has met the bulk trucking, bulk terminal, packaging, and warehousing needs of the plastics industry. Our strategic locations, …
Finance Manager, Annual Plan & FCF
Get to know Okta Okta is The World’s Identity Company. We free everyone to safely use any technology, anywhere, on any device or app. Our flexible and neutral products, Okta Platform and Auth0 Pla…
Service Desk Technician
Job Description and Duties Under general supervision of the Information Technology Services Division (ITSD) Service Desk & Field Support Information Technology (IT) Supervisor II, the Service Desk…
Community Canvassers - For Better Roads and Safe Streets
Community Canvassers and Team Leaders - Invest In Safer, Better Transportation for Fresno County Hiring Immediately - $24-26/hr + bonuses Full-time & Part-time Help us collect signatures for…
Class A Driver
Job Purpose: Our CDL Class A Truck Driver will be responsible for providing exceptional service to our clients by partnering with a successful team of innovative and value driven employees to …