Credentialing and Documentation Specialist
3 weeks ago
Qualifications, skills, and all relevant experience needed for this role can be found in the full description below.
*REPORTS TO: Director of Health Information and Compliance *
*JOB SUMMARY: *Assist in the credentialing process of practitioners with different healthcare facilities and insurance carriers. Obtain and renew required licenses, certifications and permits for each office, required departments, and practitioners. Obtain and maintain employees’ access to outside vendors’ patient information portals. Assist in reviewing and processing practitioners’ templated notes.
*EDUCATIONAL REQUIREMENTS: *
▪ High school diploma required
*QUALIFICATIONS AND EXPERIENCE: *
▪ Detail oriented
▪ Strong organizational skills
▪ Strong communication and listening skills
▪ Proficient using email and word processing software
▪ Strong understanding of orthopaedic medical terminology, anatomy and physiology
▪ Ability to perform multiple and diverse tasks simultaneously
▪ Ability to perform well in stressful situations
*Responsibilities include, but are not limited to, the following: *
*Credentialing Support *
▪ Maintain knowledge of current health plan and agency requirements for credentialing providers
▪ Maintain credentialing and re-credentialing information on various health plans and payors of the corporation
▪ Process credentialing and re-credentialing applications for the health care providers and offices
Review and verify applications for completion and accuracy prior to submitting
▪ Maintain copies of current state licenses, DEA certificates, malpractice coverage, CMEs and any other required credentialing documents for all providers/offices
▪ Set up and maintain provider information in online credentialing databases and system
▪ Track license and certification expirations for all providers to ensure timely renewals
▪ Maintain confidentiality of provider information
▪ Plan and coordinate new provider orientation
▪ Manage employees’ access to outside vendors’ patient information portals
*Documentation Support *
▪ Manage Transcription Roles for assigned templating clinicians within 48 hours of creation
▪ Creates DNKA notes
▪ Faxes Workmen’s Compensation notes for assigned templating clinicians within 24 hours
▪ Manages referral letters, printing or faxing for assigned clinicians
▪ Research address and fax discrepancies, including return to sender envelopes, and prepare correction documentation
▪ Manage messages/emails in order of priority for assigned clinicians when applicable
▪ Any other task assigned by Director of Health Information and Compliance
*Supervisory Responsibilities *
This job has no supervisory responsibilities.
*Typical Physical Demands *
Work may require sitting for long periods of time, and also stooping, bending and stretching for files and supplies. Position requires manual dexterity sufficient to operate a keyboard, operate a computer, telephone, calculator, copier, and such other office equipment as necessary. Position also requires viewing computer screens and typing for long periods of time, and working in an environment which may be stressful. Position could require occasional travel.
*Typical Working Conditions *
Normal office environment
Job Type: Full-time
Benefits:
* 401(k)
* Dental insurance
* Employee assistance program
* Health insurance
* Life insurance
* Paid time off
* Referral program
* Vision insurance
Schedule:
* 8 hour shift
* Day shift
* Monday to Friday
Application Question(s):
* What is your desired hourly pay range for this position?
Education:
* High school or equivalent (Preferred)
Experience:
* Microsoft Office: 1 year (Preferred)
* Microsoft Word: 1 year (Preferred)
* orthopaedic medical terminology, anatomy, and physiology: 1 year (Required)
Ability to Relocate:
* Orlando, FL 32806: Relocate before starting work (Required)
Work Location: In person
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