Credentialing Associate,-FT-Days- Pho

2 weeks ago

Edinburg, United States DHR Health Full time

DHR Health - US:TX:Edinburg - Days

Summary:

MISSION STATEMENT:

Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.

VISION:

Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

POSITION SUMMARY:

Under the direction of the Medical Staff Coordinator, assists in the coordination of selected Medical Staff duties. Performs general office work to support the operation of the Medical Staff Office, including typing, assisting with the preparation of confidential and special reports.

Responsibilities:

POSITION EDUCATION/ QUALIFICATIONS:
• High School Diploma/GED
• Hospital experience is preferred
• Secretarial experience is required
• Organizational skills are necessary

JOB KNOWLEDGE/EXPERIENCE:
• One year general office experience as an administrative assistant is preferred.
• Typing 50 WPM.
• Medical terminology is desired but not required.
• Knowledge of basic record keeping and filing systems is necessary.
• Demonstrates skill at written and oral communications.
• Able to work with Microsoft Word and Excel.
• Detail oriented.
• Must be well organized for prioritization of responsibilities.
• Must be able to cope with interruptions, varying personalities, and some irregular hours.
• Must possess organizational and communication skills.
• Must possess willingness to improve.
• Will be exposed to highly confidential information on providers.
• Must be able to carry out specific assignments to successful conclusion.

POSITION RESPONSIBILITES:

  • Is responsible for maintaining up-to-date the physician and allied health provider master files and validating monthly information.
  • Assisting in the completeness of all PHO members' credentialing files, including but not limited to corresponding with outside agencies regarding verification of information, querying practitioner's data bank, etc.
  • Completes monthly reviews from (including but not limited to):
  • HHS Office of Inspector General
  • State of Texas Office of Inspector General
  • Medicare Opt Out
  • EPLS
  • Assists as necessary in managed care quarterly and annual audits.
  • Assists in maintaining and updating Symplr software accurate master list of all current PHO members and maintains all credentialing information on Symplr Software.
  • Assist in reviewing new members' files for completeness and prepares and sends follow- up requests when needed.
  • Maintains confidentiality of all credentialing files and other information handled in the PHO office.
  • Assists in maintaining Symplr system in monitoring members' information - including but not limited to rosters; runs special reports as requested and shares with Manager regularly.
  • Follows up on missing information and obtains appropriate approvals.
  • Understands managed care environment and be familiar with operations of managed care organizations.
  • As needed, assists in preparing agendas, materials, as well as placing calls to confirm attendance at meetings.
  • Assists in general mailings to PHO members.
  • Assists with sending Membership Dues invoices as necessary in absence of PHO Coordinator.
  • When necessary, assists with PHO educational conferences and webinars preparation and registration.
  • Answers phones in the PHO Office as necessary; and assists physicians and their staff as necessary or forwards calls as appropriate.
  • Responsible for typing, faxing correspondence, reports etc. regarding credentialing and required by the Department.
  • Assists Manager and Director as requested.
  • All other assigned duties.

Other information:

LINES OF REPSONSIBILITES:

(Chain-of-command)

1. Manager → 2. Director

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC:

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA):

A. Essential Duties: Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:

Light/moderate lifting up to 20 lbs, from the floor to shoulder height.

Yes

Kneeling

Yes

Must be able to assist other employees with lifting more than 20 lbs.

Yes

Walking

Yes

Light/moderate carrying up to 20 lbs.

Yes

Standing/Squatting

Yes

Straight pulling

Yes

Sitting

Yes

Pulling hand over hand

Yes

Pushing

Yes

Repeated bending

Yes

Stooping/Bending

Yes

Reaching above shoulder

Yes

Climbing Stairs

Yes

Simple grasping

Yes

Climbing Ladders

No

Dual simultaneous grasping

Yes

Depth Perceptions needed

Yes

Ability to see

Yes

Identify Colors

Yes

Operating office equipment

Yes

Twisting

Yes

Operating mechanical equipment

Yes

Crawling

No

Ability to read and write

Yes

Ability to Count

Yes

Ability to hear verbal communication without aid

Yes

Operating Personal Vehicle

Yes

Ability to comprehend written/verbal communication

Yes

Other: Ability to deal with stress

Yes

OSHA Category

III

B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes: HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to "catch on" or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to "visualize" objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature: ________________________________ Date: ____________________

Transfer/Hire Date Effective: ________________________.

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