Job Title: Credentialing Verification Specialist

Job Type: Contract to potential hire
Pay: $20-24/hr (depending on experience)
Location: Decatur, GA
Hours: Mon-Fri, 8a-5p

Prestige Staffing is looking for an individual for a contract to hire role for a large hospital. The Credentialing Coordinator will work under minimal guidance and as an independent contributor, directs the review, recommendation, approval, and notification processes for credentialing activities related to the privileging of Medical Staff and Allied Health professionals for the Anesthesiology division (200 providers).

JOB DUTIES:
· Serves as a primary departmental contact between the division’s clinical leadership and the medical staff to facilitate all clinical privileging, reappointments/re-credentialing, provider licensing and billing enrollment for timely onboarding of providers for all sites.

· Partners with Departmental leadership and the credentialing office to oversee the departmental credentialing process for appointments/reappointments in compliance with the clinical site bylaws.

· Confirms providers are licensed, privileged, and enrolled in billing by their start dates and continuously during the provider’s tenure with facility.

· Ensures compliance with policies, procedures and regulatory guidelines and provides accurate verification of practitioner files for initial appointment and re-credentialing.

· Create and maintain tracking reports as requested. Identifies, investigates, and assists in the resolution of potential credentialing and enrollment issues, and participate in continual process improvement and customer service processes.

· Act as an intermediary between the employee, departmental leadership, recruitment, HR pre-employment, Employee Health, Risk & Insurance Services, and the department’s access coordinator to confirm that all pre-employment and onboarding activities are completed in a timely manner.

· Serve as a quick-turnaround specialist as needed and process requests for the credentialing and enrollment of providers during periods of high volume, departmental moves, add-ons, or as requested by leadership with responsibility for deciding and communicating the appropriate timeline, processing the file or application, and coordinating with the appropriate stakeholders to ensure the provider goes through all applicable committee processes and/or meets all applicable deadlines.

· In addition to facilitating the credentialing process, role will be perform complex assignments and responsibilities as required and resolve issues and problems referred by staff or the supervisor, participate in the development and administration of departmental policies and procedures, and oversee the maintenance of required record-keeping and documentation as determined by company policy.

· Assist department in addressing and following up on identified and escalated issues, help departmental credential coordinators interpret state, local and company policy regulations and participate in team training as requested.

MINIMUM QUALIFICATIONS:

· High school diploma or equivalent and 5 years of credentialing experience in an acute care hospital, managed care organization and/or credentialing verification organization

· A bachelor's degree and 1 year of credentialing experience

· Able to pass a criminal background check and drug test

· Able to go into the office daily

· Able to use MS Office products with ease

· Reliable and on time

· Problem solver

· Able to multitask

· MSOW or Morrisey experience

· EPIC experience a plus

· Basic knowledge of accreditation standards and state and federal credentialing related regulations and a working knowledge of medical terminology are preferred.

Job Types: Full-time, Temp-to-hire

Pay: $20.00 - $24.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No nights
• No weekends

Application Question(s):

• Do you work with CAQH or NCQA forms?

Experience:

• MSOW or Morrisey: 1 year (Preferred)
• provider enrollment/credentialing: 1 year (Required)

Ability to Commute:

• Atlanta, GA 30322 (Required)

Ability to Relocate:

• Atlanta, GA 30322: Relocate before starting work (Required)

Work Location: In person