What are the responsibilities and job description for the Credentialing Specialist position at HOPCo?
Remote position!!
Benefits:
- Competitive Health & Welfare Benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match (Part-time employees included)
- Employee Assistance Program that is available 24/7 to provide support
- Employee Appreciation Days
- Employee Wellness Events
Minimum Qualifications:
- Minimum of 2 years of credentialing experience.
- High school diploma/GED or equivalent working knowledge preferred.
- Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors, and the public
- Must be capable of establishing good working relationships with both internal and external customers.
- Some knowledge of insurance billing and hospital credentialing is a plus.
Essential Functions
- Reviews and completes hospital and payor applications for all health care providers.
- Completes verification forms/letters for outside facilities.
- Maintain billing insurance grid, provider insurance grid, and each physician’s spreadsheet up to date on current insurance changes.
- Track and maintain physician licensure(s), certification, and CME credits.
- Maintain practitioner credentialing files.
- Maintain practitioner electronic file by keeping all applications/licensure current.
- Maintains all renewal applications for both hospitals/insurances.
- Has knowledge of Employee Handbook content along with established policies and procedures.
- Relies on instructions and pre-established guidelines to perform the functions of the job.
- Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.
