LifePoint Health
Overview
Job Description - CSS Credentialing Specialist (7410-2303)
LifePoint Health Support Center
Description
The Credentialing Specialist is responsible for data entering, gathering, and primary source verification of healthcare practitioner information, including in-depth, detailed, or challenging research of information. Primary methods of researching information include phone, fax, e-mail, internet, and letters. This position needs to be knowledgeable in health care, be task oriented, and work with other team members to accurately and timely process documentation as required.
Responsibilities
General Responsibilities:
Perform primary (e.g., hospitals, licensing boards, etc.) and secondary source verifications of perspective providers' credentials with special emphasis on provider issues relating to malpractice claims, privileging, criminal concerns, license anomalies and discrepancies in education
Responsible for gathering and verifying physician information, compiling required documents, researching necessary information and verifying medical licenses
Scrutinize provider applications and resumes for consistency and accuracy
Compiles documents, researches and verifies provider backgrounds by contacting hospitals, licensing boards, medical schools, etc.
Contacts or interviews provider peer references over the phone about the providers clinical performance skills.
A minimum of 0-2 years’ experience in data entry, office administration management or medical financial experience. 0-2 years’ experience in credentialing/licensure verification/checks. Home health experience preferred. Requires excellent analytical skills, flexibility and ability to perform detailed follow through and prioritization.
Position Requirements
Competencies: To perform the job successfully, an individual will demonstrate the following competencies:
Analytical - Collects and researches data; Uses intuition and experience to compliment data. Possesses a solid attention to detail to ensure accuracy of information
Customer Service - Responds promptly to customer needs in a professional manner
Interpersonal Skills - Maintains confidentiality of all patient information and company documents
Oral Communication – Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions.
Written Communication – Writes clearly and informatively; Edits work for spelling and grammar; Presents numerical data effectively; Able to read and interpret written information
Professionalism - Approaches others in a tactful 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 - Is consistently at work and on time
Qualifications
(Experience, Education and Special Certifications…)
Associate's degree is highly preferred. A combination of education and experience will be considered.
A minimum of 3 years of credentialing or equivalent work experience is required
Have clear and concise phone and verbal communication skills ability to write legibly
Have strong computer, typing, and data entry skills: includes MS Word, Excel and web-based applications, internet, and database programs
Detail oriented with ability to recognize vital information from verification documents
Possess proof-reading skills sufficient for auditing documents
Ability to prioritize well and meet overlapping deadlines
Demonstrate problem-solving, critical thinking, and deductive reasoning skills
Ability to consistently maintain quality and production expectations
Physical Demands / Working Conditions 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Requires prolonged sitting and some bending, stooping, and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment. Requires normal range of hearing and eyesight to record, prepare, and communicate appropriate reports. Requires lifting papers or boxes up to 50 pounds occasionally. Work is performed in an office environment and involves frequent contact with staff and the public.
LifePoint Health is an Equal Opportunity Employer
EOE Minorities/Females/Protected Veterans/Disabled
This job description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this job description. The individual(s) may be called upon and required to follow or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives.
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LifePoint Health Support Center
Description
The Credentialing Specialist is responsible for data entering, gathering, and primary source verification of healthcare practitioner information, including in-depth, detailed, or challenging research of information. Primary methods of researching information include phone, fax, e-mail, internet, and letters. This position needs to be knowledgeable in health care, be task oriented, and work with other team members to accurately and timely process documentation as required.
Responsibilities
General Responsibilities:
Perform primary (e.g., hospitals, licensing boards, etc.) and secondary source verifications of perspective providers' credentials with special emphasis on provider issues relating to malpractice claims, privileging, criminal concerns, license anomalies and discrepancies in education
Responsible for gathering and verifying physician information, compiling required documents, researching necessary information and verifying medical licenses
Scrutinize provider applications and resumes for consistency and accuracy
Compiles documents, researches and verifies provider backgrounds by contacting hospitals, licensing boards, medical schools, etc.
Contacts or interviews provider peer references over the phone about the providers clinical performance skills.
A minimum of 0-2 years’ experience in data entry, office administration management or medical financial experience. 0-2 years’ experience in credentialing/licensure verification/checks. Home health experience preferred. Requires excellent analytical skills, flexibility and ability to perform detailed follow through and prioritization.
Position Requirements
Competencies: To perform the job successfully, an individual will demonstrate the following competencies:
Analytical - Collects and researches data; Uses intuition and experience to compliment data. Possesses a solid attention to detail to ensure accuracy of information
Customer Service - Responds promptly to customer needs in a professional manner
Interpersonal Skills - Maintains confidentiality of all patient information and company documents
Oral Communication – Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions.
Written Communication – Writes clearly and informatively; Edits work for spelling and grammar; Presents numerical data effectively; Able to read and interpret written information
Professionalism - Approaches others in a tactful 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 - Is consistently at work and on time
Qualifications
(Experience, Education and Special Certifications…)
Associate's degree is highly preferred. A combination of education and experience will be considered.
A minimum of 3 years of credentialing or equivalent work experience is required
Have clear and concise phone and verbal communication skills ability to write legibly
Have strong computer, typing, and data entry skills: includes MS Word, Excel and web-based applications, internet, and database programs
Detail oriented with ability to recognize vital information from verification documents
Possess proof-reading skills sufficient for auditing documents
Ability to prioritize well and meet overlapping deadlines
Demonstrate problem-solving, critical thinking, and deductive reasoning skills
Ability to consistently maintain quality and production expectations
Physical Demands / Working Conditions 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Requires prolonged sitting and some bending, stooping, and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment. Requires normal range of hearing and eyesight to record, prepare, and communicate appropriate reports. Requires lifting papers or boxes up to 50 pounds occasionally. Work is performed in an office environment and involves frequent contact with staff and the public.
LifePoint Health is an Equal Opportunity Employer
EOE Minorities/Females/Protected Veterans/Disabled
This job description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this job description. The individual(s) may be called upon and required to follow or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives.
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