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Credentialing, Contracting,

2 months ago

Garden Grove, United States Titanium Healthcare Full time
Job DescriptionJob DescriptionSalary: $23-$28

This is a part-time position scheduled to work 24/hours week.


Position Responsibilities:

  • Maintaining strong relationships with health plans, medical groups, and other third-party payors and working effectively with internal/external parties to resolve contract-related operational issues.
  • Processing all aspects of credentialing for healthcare providers within the organization.
  • Ensuring compliance with all regulatory requirements and accreditation standards.
  • Collecting, reviewing, and verifying provider credentials, including licenses, certifications, education, and work history.
  • Maintaining contract-related information in an electronic format.
  • Coordinating with insurance payers to complete provider enrollment applications.
  • Conducting primary source verification of credentials through various databases and organizations.
  • Maintaining accurate and up to date provider files and databases.
  • Coordinating with internal departments and external entities to obtain necessary documentation and information.
  • Ensuring business processes are performing within desired standards.
  • Evaluating that applications are properly verified and uploaded into the online credentialing database.
  • Working with manager to prepare credentialing and re-credentialing files for accreditation surveys.
  • Monitoring expiring credentials and initiate the recredentialing process in a timely manner.
  • Providing audit reports and conducting analysis including trend identification, and opportunities for improvement to provide individual and department level performance improvement plan. Ensuring data is accurate, consistent, complete, and valid according to established standards.
  • Respond to inquiries from providers regarding their credentialing status.
  • Maintaining current knowledge of credentialing and auditing trends.
  • Ensuring maximum confidentiality, accuracy, security, and appropriate access of all data and records provides maximum protection from discoverability of all information.
  • Performing other duties as assigned.


Position Requirements:

  • Ability to meet strict deadlines
  • Attention to detail
  • Good communication skills
  • Knowledgeable in policies, laws and procedures
  • Strong computer skills
  • Proficiency in database management
  • Willingness to work as a team player
  • Good organizational skills


Preferences (not a requirement for the role):

  • Minimum of 2 years of experience in credentialing, contracting, and enrollment within a managed care setting.
  • Knowledge of credentialing standards, regulations, and best practice.
  • Knowledge in contract evaluation
  • Knowledge in enrollment processes
  • Familiarity with credentialing software systems


Benefits: 

  • This is a hybrid role working from home and Titanium's Garden Grove headquarters
  • Medical, Dental and Vision Insurance 
  • We cover up to 100% of your premium and 50% of your dependent premium depending on the plan
  • Flexible Spending Accounts, Health Savings Accounts & Dependent Care Accounts are also available 
  • Life, AD&D and Short-Term Disability Insurance funded 100% by Titanium Healthcare 
  • 401(k) plan 
  • Employee Assistance Program 
  • 12 Paid Holidays, 3 weeks of all-inclusive PTO per year (accrual begins on the first day of employment) as well as a separate Paid Sick Time balance


Equal Employment Opportunity Commission:
At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve. We believe that achieving this mission starts with a diverse and inclusive workforce.  

 

Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply. We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.