Credentialing CoordinatorApply Now
Location: Bedford, Massachusetts
Employment Type: Contract
Contract Length: Temp to Perm
JOB SUMMARY: Verifies, researches, and evaluates credentialing data. Coordinates and ensures complete and accurate provider files for review by Credentials Committee
JOB ROLES AND RESPONSIBILITIES:
1. Performs queries in credentialing systems to assess the accuracy of credentials verifications
2. Reviews reports and provider applications against credentialing criteria
3. Reviews issues/problems with practitioner files and determines the appropriate course of action.
4. Researches and verifies postgraduate training for non-board certified providers via mail, internet, phone or fax. Evaluates postgraduate training for non-board certified providers against criteria
5. Evaluates postgraduate training for non-board certified providers against criteria
6. Documents and updates provider systems with resolution and/or status of provider issues
7. Prepares files for Credentials Committee review
8. Contacts provider offices and institutions to obtain additional information via phone, fax, internet and mail
9. Participates on special projects as needed
10. Performs all other duties and responsibilities deemed necessary.
11. Collaborate, coordinate, and communicate across disciplines and departments.
12. Ensure compliance with HIPAA regulations and requirements.
13. Demonstrate commitment to the Company's core values.
14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB REQUIREMENTS (Education, Experience, and Training):
* High School Diploma; Associates Degree or better preferred
* 2-3 years experience with database functions (maintenance and manipulation of data)
* Required licensures, professional certifications, and/or Board certifications as applicable
* Communication (written, verbal and listening) and problem solving skills
* Service oriented, flexible and ability to work under pressure
* Ability to work independently, effectively and well in both individual and team environments
* Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Microsoft Word and Excel, etc.
Shawn’s goal is to develop new and maintain existing accounts by providing them staffing solutions in the technical, functional, and human resources areas.
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