About Long Island Select Healthcare, Inc.

Long Island Select Healthcare Inc. (LISH) is a comprehensive network of community health centers. We are a Federally Qualified Health Center (FQHC) that provides Article 16 and 28 clinic services at 8 locations across Suffolk County, New York. We are a multi-specialty healthcare provider caring for our community through Primary and Specialty Medical Care, Dental, Behavioral Health, Audiology, Physical Therapy, Occupational Therapy and Speech Language Pathology. We currently provide care to over 7,000 patients and have an annual operating revenue of $22m.

LISH is a Forward-Thinking, Community-Oriented Organization!

 NYS Patient-Centered Medical Home

Chronic Care Management Program

Telemedicine & Virtual Care Services Program

Integrated Primary & Behavioral Healthcare

I. Essential Duties & Responsibilities

1. Helps to perform initial credentialing and re-credentialing for all providers including updating all supporting documentation, i.e., pertinent certificates, licenses, contracts, and agreements.
2. Assists in verifying all documentation in support of provider credentialing.
3. Assists in processing new enrollments for providers for Medicaid/Medicare.
4. Assists in filing revalidations per regulatory requirements for Medicaid/Medicare and MCO for the organization.
5. Assists in creating NPIs for the organization and providers; updating changes as needed.
6. Aids in maintenance of data base documenting status on credentialing activity.
7. Assists in maintenance of patient rosters for MCO membership on a monthly basis.
8. Assists in creating and maintenance of MCO provider portal and practice management
9. Assists in creating and updating provider roster templates for MCO
10. Assists in creating and maintenance of CAQH (Council for Affordable Quality Healthcare)

II. Competencies

• Organizational and planning skills
• Communication skills
• Information gathering and information monitoring skills
• Problem analysis and problem solving skills
• Judgment and decision-making ability
• Initiative
• Confidentiality
• Attention to detail and accuracy
• Flexibility

III. Supervisory Responsibilities

N/A

IV. Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

V. Education and/or Experience

A successful candidate must possess a high school diploma, Associates degree from an accredited institution preferred. At least 5 years of experience in credentialing for the health care sector is required. Experience may serve as substitution for the Associates degree preferred requirement.

VI. Necessary Skills & Abilities

Language Skills

Ability to read and interpret documents, such as, safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

Mathematical Skills

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.

Reasoning Ability

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Computer Skills

To perform this job successfully, an individual should have intermediate to advanced knowledge of Microsoft Office 365 (Word, Outlook, Excel) as well as experience or familiarity with other health provider programs which may be in use.

Other Skills and Abilities

Must have excellent interpersonal skills.

VII. 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is frequently required to stand and walk. The employee must occasionally lift and/or move up to 25 pounds.

VIII. Travel

As needed on an infrequent basis

IX. Work Environment

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.