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Credentialing Specialist

935 State Farm Road, Boone, NC, USA

Job Type

Full Time

About the Role

Nature of Position: Broad knowledge of General Accounting needed. Non-Profit experience a plus. Responsibilities include Credentialing for medical, behavioral health, and dental providers. Reports to the Reports to the Director of Program Revenue Development.

Provider Credentialing Responsibilities:
· Assist the Director in performing credentialing and enrollment activities in order to satisfy all requirements specified by commercial, governmental and other payor entities
· Track and collect credentialing and privileging program data to ensure information is compliant with the needs of the program
· Perform administrative tasks such as document preparation, verbal and electronic communication, copying and filing, using database management system and project management
· Maintain credentialing databases, using Excel and other external credentialing systems
· Interaction with insurance payors, contracting, credentialing, and researching
· Liaison with HCCH billing, HR, clinical, and QI departments
· Maintain and distribute provider and insurance listings

Provider Continuing Education Responsibilities:
· Maintain CE balances for dollars and days
· Send out quarterly reports to providers for CE balances
· Keep records of Employee Agreements with CE allowances for each provider
Performs other related duties incidental to the work described herein and as assigned.

Requirements

· Some college experience preferred

· At least two years of office experience preferred

· Competent with computers including Microsoft Windows/Office programs, specifically Microsoft Word, Excel, database management

· Excellent customer service to both internal and external customers

· Willingness to work cooperatively in a team setting

· Ability to demonstrate accuracy and thoroughness ensuring the highest possible quality

· Ability to maintain a strong work ethic without direct supervision at all times

· Effective oral and written communication

· Ability to make timely, informed decisions that take into account the facts, goals, constraints, and risks related to all aspects of the organization 

· Maintain the highest level of confidentiality

About the Company

"HCCH provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HCCH complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
HCCH conducts background checks on all final candidates. Employment is contingent upon a clear background check or approval of the CEO"

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