What are the responsibilities and job description for the Credentialing Specialist position at US Tech Solutions?
Duration: 6 months contract
Job Summary:
The Credentialing Analyst / Coordinator is responsible for the data analysis and/or the initiating credentialing and re-credentialing of nurse practitioners, physician assistants, Behavioural Health Providers and physicians in a compliant and timely manner; monitor expired credentials and compliance monitoring in accordance with Joint Commission accreditation, NCQA and URAC credentialing standards as required.
Job Description:
- Responsible for the timely and accurate processing of all providers including NP’s/PA’s/MD’s Re-credentialing applications according to the Client’s Provider Credentialing Program
- Monitor Expired licensure reporting , data base tasks and maintain system updates and weekly reporting to leadership
- Manage Epic access for any providers that have out of compliance licensure and/or board certification.
- Analyst will work directly with other coordinators to ensure quality of work delivered, performance/productivity benchmarks are met, and all compliance related issues are properly addressed, trained and coached on a consistent basis.
- Conduct sanctions and compliance monitoring and alert Data Analyst Manager and Credentialing Manager of any undisclosed negative findings
- Process malpractice insurance verification requests according to internal policies when applicable
- Maintain the provider and physician SharePoint sites and Communicate provider statuses with leadership and other internal teams to meet timelines
- Submit system access requests upon credentialing approvals/clinic eligibility
- Support the payer enrolment team as needed to resolve any payer claim issues
- Monitor Provider and Clinic change/Termination reports and update data base accordingly
- Process Name changes according to Client’s policies and procedures
- Daily maintenance of provider credentialing grids with notification to appropriate teams
- Review and distribute all incoming mail as needed
- Support Payer Audits in accordance with Minute Clinic, Joint Commission and NCQA requirements
- Maintain provider files with the most current information/documentation
- Notify system analyst and leadership of any system and state agencies interruptions / updates / password changes
- Make recommendations for process improvement and system efficiencies
- Attend and engage in all team meetings
- Model a positive attitude in interactions with team members
Experience:
3 years’ experience in the healthcare industry with experience in credentialing
Skills:
- Credentialing
- NCQA
- Healthcare
Education:
Associate or bachelor’s Degree required.
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
US Tech Solutions is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Recruiter Details:
Name: Akash Kumar Sharma
Email: AkashS@ustechsolutionsinc.com
Internal Id: 25-33938
Salary : $23 - $25
