PROVIDER CREDENTIALING SPECIALIST

4 weeks ago

Atlanta GA USA, United States Sonder Health Plans Full time
About Us

Sonder Health Plans, Inc.

We know you are not just a number.

We are not just another health plan.

Work with the health plan as unique as you are.

Qualifications

* One to three (1-3) years of directly related credentialing experience.
* Knowledge of medical terminology and strong communication skills
* Credentialing platform software experience.
* Ability to practice confidentiality and follow HIPAA regulations with patient information; ability to oversee HIPAA compliance by other staff.
* Ability to practice professional ethics and use discretion.
* Skilled in using computers with a typing speed of 40 wpm or greater.

Responsibilities and Duties

* Initiate the credentialing and enrollment process for providers as soon as a contract is signed.
* Monitor all credentialing, re-credentialing, enrollment and DEA application processes.
* Follow up with vendors as needed to ensure compliance.
* Accurately and securely clinical staff member data files.
* Submit provider/clinical staff documentation to Board of Directors for review and approval.
* Track the credentialing and re-credentialing process from start to finish ensuring it is completed in a timely manner.
* Maintains constant contact with provider/clinical in the credentialing process to ensure all documents are provided and data is accurately recorded.
* Maintains tracking system for credentialing renewal dates for providers and clinical support personnel.
* Works to verify all necessary documents are provided and contacts made to ensure clinical practicing privileges with insurance plans are complete for each provider.
* Maintains highly organized credentialing files. Monitors and tracks training programs for all personnel.
* Provides timely updates to Inhouse Clinical Staff.
* Receives, tracks, monitors and facilitates CME requests and other educational certifications.

Position Requirements

* Associates Degree.
* One to three (1-3) years of directly related credentialing experience
* Proficient knowledge of the following applications MS Outlook, Word, Excel, Powerpoint

Job Type: Full-time, Contract

Pay: $18.00 - $24.00 per hour

Benefits:

* 401(k)
* Dental insurance
* Flexible schedule
* Health insurance
* Life insurance
* Paid time off
* Vision insurance

Work Location: One location

Schedule:

* 8 hour shift
* Day shift
* Monday to Friday

Ability to commute/relocate:

* Atlanta, GA 30339: Reliably commute or planning to relocate before starting work (Required)

Education:

* High school or equivalent (Preferred)

Experience:

* Provider Credentialing: 1 year (Required)
* Customer service: 1 year (Required)

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