Credentialing Specialist

1 month ago

orlando, United States Loyal Source Government Services Full time

POSITION PURPOSE

The role of Credentialing Specialist is a critical position for the credentialing department. The purpose of this position is to facilitate the timely completion and delivery of credentialing files as well as maintaining the databases used for the tracking and storage of credentials. The roll of Credentialing Specialist requires an extreme attention to detail, dedication to purpose, and an appropriate sense of urgency. A person succeeding in this roll will bring a desire to enhance and improve existing systems and procedures through unique problem solving and time management techniques.


ESSENTIAL FUNCTIONS AND BASIC DUTIES

The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by our customers.

  • File completion to include, but not limited to:
  • Primary Source Verifications.
  • Employment Verifications.
  • Reference Verifications.
  • Maintain all credentialing tracking logs for providers currently working on assignment or in between assignments.
  • Request and pursue obtaining copies of all required renewable credentials prior to their expiration.
  • Reminders will be sent to providers at 90, 60 , and 30-day intervals and then weekly within the last 30 days prior to expiration.
  • If a renewable credential cannot be obtained prior to expiration, specialist will communicate the deficit to the appropriate Program/Account Manager so that appropriate action can take place.
  • Send copies of updated credentials to customers as directed, prior to expiration.


PERFORMANCE MEASUREMENTS

  • All required records are up-to-date, accurate, and in compliance with company policy.
  • Credentialing functions are conducted in accordance with established Company policies and legal requirements.
  • Clinicians are treated professionally and well informed of their status of credentialing file.
  • Good coordination and effective working relations exist with other departments. Assistance is provided as needed.
  • Management is well informed of area activities and of any significant problems.


QUALIFICATIONS


EDUCATION/CERTIFICATION: Bachelor’s Degree is required for this position or a medical certification such as a CMA or CNA.


REQUIRED KNOWLEDGE: Basic understanding of healthcare terminology processes and strategies.


EXPERIENCE REQUIRED: One year or more of administrative experience, preferably in healthcare.


SKILLS/ABILITIES:

  • Communicates and works well with others in a team environment.
  • Good customer service and public relations.
  • Knowledge of related computer applications including database entry.
  • Excellent phone skills.
  • Able to work well independently and in a team environment.
  • Attention to detail and solid organizational skills.


MENTAL ACTIVITIES AND REQUIREMENTS OF THIS POSITION


REASONING ABILITYLY: Ability to apply common sense understanding to carry out detailed but uninvolved instructions and to deal with problems involving a few variables.


TECHNOLOGICAL ABILITY: Competent in the use of MS Word and Excel.



About Loyal Source

Loyal Source is an Orlando-based workforce solutions provider dedicated to delivering elite services worldwide, with a focus in government healthcare, technical and support services, engineering, and travel healthcare. Loyal Source provides exceptional custom solutions to both private enterprise and government agencies. Loyal Source is a military friendly employer and proud partner of the Military Spouse Employment Partnership program.


For more information go to our website www.loyalsource.com and follow us on LinkedIn, Facebook & Twitter for other positions currently open.

Loyal Source does not discriminate in employment based on race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factors.

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