Credentialing Specialist

Credentialing Specialist Corning

Rolling Hills Clinic
Full Time Corning 10.56 - 12.04 Today
Job description

JOB DESCRIPTION JOB TITLE: Credentialing Specialist REPORTS TO: Patient Services and Billing Manager DEPARTMENT: Administration LOCATION: Rolling Hills Clinics 705 East St, Corning, CA 96021 STATUS: Full-time, 100% FTE, Non-Exempt, 40 hours per week Native Preference in hiring is given to qualified enrolled members of Paskenta Band of Nomlaki Indians and Native Americans in accordance with the Band’s Preference Policy (Chapter 1-715 of the Paskenta Band of Nomlaki Indians Tribal Policies). Applicants claiming Indian Preference must submit verification of Indian certified by tribe of affiliation or other acceptable documentation of Indian heritage.” POSITION SUMMARY The Credentialing Specialist is responsible for maintaining active status for all providers, and ensuring all providers are properly credentialed with all payers affiliated with RHC. DUTIES & RESPONSIBILITIES 1. Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. 2. Maintain internal provider grid to ensure all information is accurate and logins are available. 3. Maintain accurate and up to date provider profiles on CAQH, PECOS, NPPES, and CMS databases. 4. Complete revalidation requests issued by government payers. 5. Complete credentialing, re-credentialing, and privileging applications to add providers to commercial payers, Medicare, and Medicaid. 6. Work closely with the Director of Revenue Cycle and billing company staff to identify and resolve any denials or authorization issues. 7. Must maintain compliance with ergonomic safety standards; be mindful of posture and regularly practice ergonomic stretches. 8. Employee Safety: Safely performs all duties; follows required protective protocols to ensure personal safety as well as the safety of others. 9. Safety: Responsible for ensuring that all duties, responsibilities, and operations are performed with the utmost regard for the safety and health of all personnel involved, including themselves. 10. Other duties as assigned by Supervisor. REQUIREMENTS Minimum 18 years of age Valid California Driver’s License MINIMUM QUALIFICATIONS 1. Associates degree (preferred). 2. 2 years of credentialing experience in an FQHC medical and dental practice preferred. 3. Fluent in Medical terminology preferred. 4. Ability to communicate professionally. 5. Ability to handle multiple tasks simultaneously. 6. Ability to work autonomously, using discretion as appropriate. 7. Ability to manage and maintain confidential information. 8. Highly proficient in MS Office. 9. General knowledge of finance and accounting functions, policies, practices, and terminology. 10. Strong interpersonal skills, including excellent written and verbal communication skills. 11. Strong editing/grammar/punctuation skills. 12. Strong attention to detail. 13. Strong organizational skills. 14. Demonstrate clear knowledge of Rolling Hills Clinic structure, standards, procedures, and protocols. 15. Must have ability to relate and communicate effectively with community interest groups, agencies, and medical facilities that serve the American Indian Community. BACKGROUND CHECK REQUIREMENTS Pre-employment Drug Testing and a Department of Justice Fingerprinting clearance through Federal, State and Child Abuse Index is a contingency for an offer of employment. Criminal clearances are obtained to protect the welfare and safety of clients receiving services at Rolling Hills Clinic. VACCINATION REQUIREMENTS A pre-employment Physical exam is required upon hire. You will be required to provide vaccination records to show proof of immunity for TB or PPD, Measles, Mumps, Rubella, Varicella, TDAP & Hep B. If the records are more than 10 years old, titers are required to confirm immunity. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to stand, walk, sit, use hands to finger, handle, or feel; and reach with hands and arms. The employee is occasionally required to stoop. The employee must occasionally lift and/or move up to 25 pounds. Position may require exertion up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently or constantly lift, carry, push, pull or otherwise move objects. Specific vision abilities required by this job include close vision, distance vision, color vision peripheral vision, depth perception and ability to adjust focus. WORK ENVIRONMENT Work is performed in a health clinic setting. The noise level in the work environment is usually low to moderate. Will work with blood-borne pathogens and will require OSHA training. This job routinely uses standard office equipment such as computers, telephones, photocopiers, and fax machines. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Employment with Rolling Hills Clinic is voluntarily entered into. All RHC personnel are employed on an at-will basis. At-will employment may be terminated with or without cause, and with or without notice at any time by the employee or by RHC. No manager, supervisor, or employee of the organization has any authority to enter into an agreement for employment for any specified period of time or to make an agreement for employment other than at-will terms. The job description does not constitute an employment agreement between Rolling Hills Clinic and employee and is subject to change by the Paskenta Band of Nomlaki Indians. Job Type: Full-time Pay: From $20.00 per hour Expected hours: No less than 40 per week Benefits: 401(k) matching Dental insurance Employee discount Health insurance Life insurance Paid time off Vision insurance Schedule: Monday to Friday Ability to commute/relocate: Corning, CA 96021: Reliably commute or planning to relocate before starting work (Required) Experience: Microsoft Office: 1 year (Preferred) Work Location: In person

Credentialing Specialist
Rolling Hills Clinic

http://rhclinic.org/employment
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