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Scope of Position : Maintain an efficient provider credentials system by ensuring completed credentials CAQH profiles and / or applications are received and processed, correct data entry, and updated regulatory and credentialing documents are entered and / or scanned into the Doctors HealthCare Plans, Inc, ( DHCP ) credentialing CACTUS database, provide data entry and clerical support to the Credentialing Department.
This position will assist the Credentialing Department in the timely processing of Initial Credentialing / Recredentialing of application, processing incoming and outgoing documents, and requesting required credentials documents.
Creating file folders for each new practitioner (e.g. Physician, Ancillary, and or Allied Health Practitioners). Processing practitioner recredentialing application within 3 years of initial credentialing date.
Filing or scanning documents received. Assisting Credentialing Director or designee with various tasks, as needed. Receiving, sorting, and distributing incoming mail and faxes as needed.
Maintaining thorough operational knowledge of the DHCP Credentialing CACTUS Database. Maintaining thorough operational knowledge of the appropriate Credentialing Policies & Procedures.
Annually providing input into updating Credentialing Procedures. Performing other related duties as required. Qualifications : Minimum of two (2) years previous experience in a managed care organization’s Credentialing department.
NAMSS CPCS certification is preferred, or a commitment to pursue certification within two years. Knowledge of basic medical terminology.
Ability to analyze data and make appropriate decisions. Ability to work as a team under stressful conditions. Good verbal communication skills Bilingual English and Spanish - (preferred but not required) Excellent organizational skills.
Extremely detail-oriented. Ability to maintain confidentiality. Minimum typing skills of 45 WPM. PC proficiency and Windows-based software knowledge (Microsoft Word, Excel, Outlook) required.
Duties described are not to be interpreted as being all-inclusive or specific to any individual team member. No Third Party Agencies or Submissions Will Be Accepted.
Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
DFWP Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients.
Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein. Powered by JazzHR
Last updated : 2024-07-02
Full Time
$43k-54k (estimate)
07/03/2024
10/02/2024
doctorshcp.com
CORAL GABLES, FL
25 - 50
2017
Private
RAFAEL PEREZ
$5M - $10M
The job skills required for Credentialing specialist include Managed Care, Data Entry, Microsoft Word, Verbal Communication, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Credentialing specialist positions, which can be used as a reference in future career path planning. As a Credentialing specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing specialist. You can explore the career advancement for a Credentialing specialist below and select your interested title to get hiring information.
If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Credentialing Specialist job description and responsibilities
A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.
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A credentialing specialist can have certificates that will prove useful to their field.
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Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
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Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.
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Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Credentialing Specialist jobs
Credentialing specialists can often find work with a high school diploma or the equivalent.
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Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.
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While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.
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Make Use Of Advanced Software For Monitoring.
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Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
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Step 3: View the best colleges and universities for Credentialing Specialist.