Credentialing & Contracting Department

  • 사무직
  • Anaheim
  • hans
  • 6/30/2020
Credentialing & Contracting Department

Description
Responsible for data entering and document verification of healthcare provider information through in depth detailed research of information. Primary methods of researching information include internet, phone, fax and e-mail. Responsible for expanding/maintaining the provider network through contracting efforts.
Credentialing
• Contact providers to initiate initial credentialing or re-credentialing process
• Update expired documents such State licenses, DEA licenses, and malpractice insurances
• Manage and organize the credentialing folders and files
• Input provider data through user friendly database
• Create monthly credentialing meeting minutes
• Assist the department with regular health plan audits
• Perform other duties as assigned
Contracting
• Obtain contracts and letters of agreement (LOAs) from providers who want to join our network
• Coordinate with other departments to obtain contracts/LOAs with requested providers
• Call/follow-up with providers on a regular basis to obtain contracts/LOAs
• Prepare contracts/LOAs for monthly credentialing board meeting
 
Qualifications
• High school graduate/diploma
• Comfortable being on the phone /proper phone etiquette
• Have strong computer and typing skills: includes MS Word, Excel, Adobe, and Internet
• Detail oriented with ability to recognize vital information when verifying  documents
• Possess proof-reading skills sufficient for auditing documents
• Ability to prioritize well and meet overlapping deadlines
• Demonstrate effective written/verbal communication skills
• Demonstrates problem-solving, critical thinking, and deductive reasoning skills
 
Preferred Qualifications
• At least 1 year of credentialing experience (Medicare Advantage/Managed Medicare)
• Familiar with the credentialing process; with what type of organization/company an MSO is; with health care/managed care
Schedule
Monday to Friday (all days)
8:30 AM to 5:30 PM (whole duration, 1-hour lunch in between)
Job Type: Full-time
Location:
• Anaheim, CA (Required)
Work authorization:
• United States (Required)
Working Days:
• Monday (Required)
• Tuesday (Required)
• Wednesday (Required)
• Thursday (Required)
• Friday (Required)

Resume submission: info330amm@gmail.com
 

[원본 글 보기]
 
0 Comments
If you are not logged in, you cannot delete your comment and your comment will be reviewed before it is displayed. [Login]