Credentialing Associate, FT Days
1 day ago
Job Summary:
We are seeking a highly organized and detail-oriented Credentialing Associate to join our team at DHR Health. The successful candidate will assist in the coordination of medical staff duties, perform general office work, and provide exceptional customer service to our patients and healthcare providers.
Responsibilities:
- Maintain up-to-date physician and allied health provider master files and validate monthly information.
- Assist in the completeness of all PHO members' credentialing files, including corresponding with outside agencies and querying practitioner's data bank.
- Complete monthly reviews from various sources, including HHS Office of Inspector General and State of Texas Office of Inspector General.
- Assist in managed care quarterly and annual audits.
- Maintain and update Symplr software with accurate master lists of all current PHO members and credentialing information.
- Review new members' files for completeness and prepare follow-up requests as needed.
- Maintain confidentiality of all credentialing files and other information handled in the PHO office.
- Assist in monitoring members' information on Symplr system, including running special reports and sharing with Manager regularly.
- Follow up on missing information and obtain appropriate approvals.
- Understand managed care environment and be familiar with operations of managed care organizations.
- Assist in preparing agendas, materials, and placing calls to confirm attendance at meetings.
- Assist with general mailings to PHO members and sending Membership Dues invoices as necessary.
- Assist with PHO educational conferences and webinars preparation and registration.
- Answer phones in the PHO Office and assist physicians and their staff as necessary or forward calls as appropriate.
- Responsible for typing, faxing correspondence, reports, and other documents related to credentialing and required by the Department.
- Assist Manager and Director as requested.
- Perform all other assigned duties.
Requirements:
- High School Diploma/GED
- Hospital experience is preferred
- Secretarial experience is required
- Organizational skills are necessary
- 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
Working Conditions:
The individual spends over 95% of their 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.
Aptitudes:
High learning ability, verbal ability, numerical ability, spatial ability, form perception, clerical perception, motor coordination, finger dexterity, manual dexterity, eye-hand-foot coordination, and color discrimination.
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