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Provider Credentialing Specialist
2 months ago
Location: Missoula, MT
Job Type: Regular Full-time, 40 hours/week
Department: Partnership Health Center
Bargaining Unit: MFPE - Local 8512
Scheduling/Hours of Work: Regular, Full-Time, 40 Hours per Week
Position Overview:
As a key member of the Medical Staff Office, the Credentialing Coordinator plays a vital role in the evaluation and verification of healthcare providers' qualifications. This position is responsible for ensuring that all practitioners meet the necessary standards to deliver quality care at Partnership Health Center (PHC).
Key Responsibilities:
1. **Credentialing Management:**
- Oversee the collection and assessment of practitioner applications and supporting documents to confirm eligibility and qualifications.
- Maintain comprehensive credentialing records and ensure data security and confidentiality.
2. **Documentation Evaluation:**
- Gather and analyze educational, training, and work history documentation for new and existing providers.
- Ensure compliance with licensure and regulatory standards while maintaining accurate provider files.
3. **Roster Administration:**
- Manage the internal roster of healthcare professionals, ensuring all information is current and precise.
- Facilitate the enrollment of providers in national databases and manage their online profiles.
4. **Insurance Application Processing:**
- Prepare and submit credentialing applications to various insurance payers, including Medicare and Medicaid.
- Track the status of applications and respond to inquiries from external agencies.
5. **Committee Coordination:**
- Organize and document Credentialing Committee meetings, ensuring all minutes and reports are accurately maintained.
Qualifications:
- A minimum of a High School diploma or GED is required.
- Four years of experience in a medical office setting is preferred, with credentialing experience being a plus.
- Certification as a Certified Provider Credentialing Specialist (CPCS) is desirable.
Skills and Abilities:
- Proficient in the use of office software and strong typing skills.
- Excellent communication skills, both verbal and written, with a focus on confidentiality and cultural sensitivity.
- Ability to manage multiple tasks in a fast-paced environment while maintaining attention to detail.
Work Environment:
The role is primarily based in office settings within healthcare facilities, requiring occasional light lifting and flexibility in working hours.
Benefits:
Missoula County offers competitive compensation and a comprehensive benefits package, including medical, dental, and vision coverage, retirement plan options, and generous paid leave policies.
