What are the responsibilities and job description for the Credentialing Specialist - Credentialing Resource Office position at SCA Health?
Overview:
As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:
The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.
Accountabilities / Responsibilities:
Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.
As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:
- We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
- We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
- We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
- We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.
The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.
- Credentials Facility, Radiologists, and Modalities with participating carriers and regulatory agencies in a timely and efficient manner. This includes re-credentialing of existing services and initial credentialing of new services or new Payors.
- Maintains credentialing process for Facility, all Modalities, and all Radiologists.
- Informs management of any credentialing process or procedure roadblocks.
- Maintains an accurate database of all Facility, Modality, and Radiologist participation information.
- Responds and manages all credentialing related requests from regulatory agencies, Payors, and outside affiliates.
- Informs the Center Administrator and/or Radiologists of tasks or information required to maintain licensure and credentialing as appropriate.
- Maintains continuing education credits and informs Radiologists of deficiencies.
- Supports the objectives of the Center Administrator and Radiologists.
- Adheres to all HIPAA, OSHA, regulatory, compliance, privacy and confidentiality standards at all times, maintaining patient confidentiality at all times.
- Demonstrates a willingness and ability to assist others as requested; perform receptionist / clerical responsibilities and other assignments.
- Attends regularly scheduled facility meetings (i.e. in-service, training, staff).
- Keeps work area in a pristine and organized condition; regularly checking equipment, accessories, and supplies; keeping area stocked at all times; cleans and disinfects equipment after each patient use.
- Demonstrates a clear understanding of, consistently adheres to, facility policies and procedures.
- Promotes and supports the company’s Vision / Mission / Values.
- Other duties as assigned.
- High school diploma or equivalent.
- At least 2 years of previous related experience (Physician, Payor, or Hospital).
- Experience working with computers, MS Office, and credentialing systems.
Salary : $52,000 - $54,080
