What are the responsibilities and job description for the Onboarding, Credentialing, and Compliance Specialist position at Centria Healthcare?
Position Overview:
The Onboarding, Credentialing, and Compliance Specialist will organize, maintain, and verify all aspects of the process and maintain current clinical and field-based staff files. This role is responsible for facilitating all aspects of credentialing and compliance for clinical and field-based personnel. Additionally, they will provide a positive customer service experience to team members, including clinical and field staff and payors, by being the point of contact and assisting them with related inquiries.
Success measures include adherence to Centria policies, flawless execution of tasks, and meeting or exceeding personal qualitative and quantitative key performance indicator (KPI) metrics.
The below reflects the essential functions considered necessary for this role and shall not be construed as a detailed description of all work requirements inherent in the job or assigned by supervisory personnel. This job description is used as a guide only and not inclusive of all responsibilities and job duties.
- Manage candidate applications and associated pre-hire requirements.
- Communicate regulations, policies, and procedures to team members, including clinical and field staff.
- Engage candidates and assist with setting schedules and expectations, enrolling them in required courses, and tracking completion of activities.
- Create applicable internal and external accounts as needed.
- Assist clinical and field staff in applying/registering for certifications, licensure, etc., needed for credentialing.
- Obtain and review certifications, licenses, and other required credentialing documents to maintain up-to-date personnel files.
- Submit and follow up with payor credentialing applications via phone, email, or proprietary portals.
- As needed, alert and enroll clinical and field staff in required courses based on the payor, state, and federal regulations and track completion.
- Review documentation for accuracy and ensure compliance with Centria, payor, state, and federal mandates.
- Track clinical and field staff compliance and communicate to the appropriate individuals to ensure receipt before expiration, update internal and external systems with compliance and credentialing documents.
- Assist with audits from external and internal sources and ensure timely completion.
- Perform dormant team member follow-up and offboarding tasks as needed and in compliance with Centria guidelines.
- Compliance with Centria's Code of Conduct, policies and procedures, and Federal and State laws
- Responsibility to report violations of Company policies or the Code of Conduct.
Required Skills, Qualifications and Knowledge:
- Associate Degree or equivalent experience
- Minimum of 1-2 of experience in administrative or customer service experience
- Data entry experience preferred
- Basic computer skills
- Proficiency in Microsoft Suite, especially Excel
- Proficiency in G Suite
- Ability to follow written instructions
- Ability to use computers and computer/software programs
- Ability to communicate expressively and receptively
- Ability to organize, prioritize and handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks;
- Effective communication skills, both written and verbal, with internal and external stakeholders;
- Ability to build rapport with team members, including clinical and field staff, explain complicated information in an approachable and easily understood manner, effectively handle challenging phone conversations, and represent the Centria brand;
- Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business outcomes;
- Results-driven with the aptitude to apply critical thinking skills and problem-solving;
- Excellent interpersonal and listening skills;
- Demonstrated strong work ethic with attention to detail, accuracy, and quality;
- Established track record of generating error-free work.
Working Conditions:
Centria's office hours are Monday through Friday from 8:30am-6:00pm. Additional time may be required to complete above work or meet company objectives. Overtime is not a planned part of this role; if required, overtime must be pre-approved by a leader in the department.
Additional time or occasional shifts in schedule may be required to complete the above work or meet company objectives.
Physical Requirements:
While performing the duties of this job, physical requirements such as bending, reaching, lifting, pushing, or pulling up to 30 pounds may be required. This role will require sitting most of the day as well as walking and standing periodically. This role may require close visual acuity on computer screens or monitors and the ability to analyze data and figures on a screen.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, Veteran status, or disability status. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position. Centria reserves the right to amend this job description at any time, with or without written notice.
