What are the responsibilities and job description for the Credentialing Specialist position at WinMax Systems Corporation?
Job Details
Title: Credentialing Specialist
Location: Alpharetta, GA (onsite)
Contract: 12 Month
Job Description:
Screens provider credentialing and re-credentialing packets for missing information; requests missing information from provider; resolves discrepancies between information supplied and findings of other sources (State Dental or etc.);
Creates and updates provider information in the credentialing system to ensure that credentials are completed within a timely manner and at a high level of accuracy.
Receives provider inquiries via phone and correspondence. Researches and verifies detailed information on provider participation status. Perform verification of all applicable credentials.
Contact providers for missing and expired information.
Processing mail; incoming and outgoing.
Performs miscellaneous duties as assigned.
Creates and updates provider information in the credentialing system to ensure that credentials are completed within a timely manner and at a high level of accuracy.
Receives provider inquiries via phone and correspondence. Researches and verifies detailed information on provider participation status. Perform verification of all applicable credentials.
Contact providers for missing and expired information.
Processing mail; incoming and outgoing.
Performs miscellaneous duties as assigned.
Skills/Experience:
Job Requirements:
Job Requirements:
A high school diploma or GED is preferred, but candidates with proven experience will not be excluded from consideration.
A minimum of 2 years related experience.
Knowledge of clientl products, policies and terms of provider participation in various networks is expected at conclusion of training and any applicable probationary period.
Ability to maintain confidentiality of providers information.
Demonstrated understanding of basic corporate structures and how to accurately translate information provided on contracts, credentialing attestations and other sources to maintain provider records.
Math skills to compile and validate statistical computations, reconcile discrepancies, and insure the validity and accuracy of results.
Knowledge and application of English grammar including composition, editing and proofreading skills.
Basic organizational/time management and project management skills and multi-tasking abilities.
Detail oriented with analytical and problem solving skills. Knowledge of health care industry issues preferred.
Ability to accurately enter relevant information into the credentialing system and other ancillary data repositories as needed.
Must be able to understand fairly complex written and oral instructions.
Ability to clearly present written information and findings. Ability to communicate concepts.
Ability to interact well with co-workers and outside contacts.
PC literacy; MSOffice skills (competency in Word, advanced skill in Excel, Access and other database applications).
Regularly required to work standard office equipment (personal computer, photocopy machine, fax machine, etc.).
Ability to work on a computer up to 7 hours a day.
Regularly required to sit for long periods of time, and occasionally stand and walk.
Regularly required to use hands to operate computer and other office equipment.
Close vision required for computer usage. Occasionally required to stoop, kneel, climb and lift up to 25 pounds.
Required Skills:
Microsoft Office skillset
Strong communication skills, verbal and written
Home internet, office equipment
Desired Skills:
Moderate to advanced Excel skillset
A minimum of 2 years related experience.
Knowledge of clientl products, policies and terms of provider participation in various networks is expected at conclusion of training and any applicable probationary period.
Ability to maintain confidentiality of providers information.
Demonstrated understanding of basic corporate structures and how to accurately translate information provided on contracts, credentialing attestations and other sources to maintain provider records.
Math skills to compile and validate statistical computations, reconcile discrepancies, and insure the validity and accuracy of results.
Knowledge and application of English grammar including composition, editing and proofreading skills.
Basic organizational/time management and project management skills and multi-tasking abilities.
Detail oriented with analytical and problem solving skills. Knowledge of health care industry issues preferred.
Ability to accurately enter relevant information into the credentialing system and other ancillary data repositories as needed.
Must be able to understand fairly complex written and oral instructions.
Ability to clearly present written information and findings. Ability to communicate concepts.
Ability to interact well with co-workers and outside contacts.
PC literacy; MSOffice skills (competency in Word, advanced skill in Excel, Access and other database applications).
Regularly required to work standard office equipment (personal computer, photocopy machine, fax machine, etc.).
Ability to work on a computer up to 7 hours a day.
Regularly required to sit for long periods of time, and occasionally stand and walk.
Regularly required to use hands to operate computer and other office equipment.
Close vision required for computer usage. Occasionally required to stoop, kneel, climb and lift up to 25 pounds.
Required Skills:
Microsoft Office skillset
Strong communication skills, verbal and written
Home internet, office equipment
Desired Skills:
Moderate to advanced Excel skillset
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
