Community Health Systems Credentialing Verification Specialist in Nashville, Tennessee
Summary: Physician Practice Support strives to maintain a culture of collaboration, excellence, leadership, and respect. The Credentialing Verification Services department seeks staff that is committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our success.
This position facilitates the credentialing, recredentialing and privileging of medical providers for the Community Health Services (CHS) physician practices. Ensuring providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities. Maintain up-to-date data for each provider and credentialing databases and online systems; ensure timely renewal process of licenses and certifications.
Essential Duties and Responsibilities: Include the following . Other duties may be assigned.
Compiles and maintains current and accurate data for all providers.
Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed.
Maintains copy of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
Maintains knowledge of current health plan and agency requirements for credentialing providers.
Sets up and maintains provider information in online credentialing databases and systems.
Processes applications for appointment and reappointment of privileges.
Tracks license and certification expirations for all providers to ensure timely renewals.
Tracks license, DEA and professional liability expirations.
Maintains compliance with NCQA standards
Supervisory Responsibilities: This job has no supervisory responsibilities
Analytical- Collects and researches data; possesses a solid attention to detail to ensure accuracy of information
Base Knowledge– Managed care and insurance plan types
Customer Service- Responds promptly in a professional manner to all requests for credentialing documentation or questions
Interpersonal Skills- Maintains confidentiality of all provider information and company documents
Communication– Speaks clearly and concisely: must have excellent interpersonal and written communication skills: Able to read and interpret written information
Professionalism- Approaches others in a professional manner; Treats others with respect and consideration regardless of their status or position. Maintains positive business relationships.
Quality- Demonstrates accuracy and thoroughness
Quantity- Meets performance and / or productivity standards
Adaptability- Adapts to changes in the work environment
Attendance/Punctuality– follows attendance policy
Knowledge: Maintains confidentiality of all provider information and company documents. Speaks clearly and concisely: must have excellent interpersonal and written communication skills: Able to read and interpret written information. Responds promptly in a professional manner to all requests for credentialing documentation and/or questions.Experience with Word, Excel, Outlook, and use of data management systems. Must demonstrate the ability to work independently, resolve issues, solid attention to detail. Ability to adhere to strict deadlines, performance standards and quality measures.
Education and/or Experience Preferred: High school diploma or general education degree (GED); 2 years of credentialing experience; or equivalent combination of education and experience.
Reasoning Ability: Ability to apply common sense understanding to carry out detailed written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
Computer Skills: S trong keyboarding skillsand aworking knowledge of Microsoft Office (Word / Excel).
Physical Demands: Thephysicaldemandsdescribedherearerepresentativeofthosethatmustbemetbyanemployeetosuccessfullyperformtheessentialfunctionsofthisjob.Reasonableaccommodationsmaybemadetoenableindividualswithdisabilitiestoperformtheessentialfunctions.WhileperformingthedutiesofthisJob,theemployeeisregularlyrequiredtosit;usehandstofinger,handle,orfeelandtalkorhear.Theemployeeisoccasionallyrequiredtoreachwithhandsandarmsandstoop,kneel,crouch,orcrawl.Theemployeemustoccasionallyliftand/ormoveupto10pounds.Specificvisionabilitiesrequiredbythisjobincludeclosevision,distancevisionandabilitytoadjustfocus. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Job: Business Office Support
Organization: Credential Verification Services
Requisition ID: 1806635