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Job Description
Sentara Health is seeking to hire a qualified individual to join our team as a Coding Credentialing Specialist II
Position Status : Full-time, Day Shift
Position Location : This position is remote for residents of VA (traveling flexibility is required).
Standard Working Hours : 8 : 00AM to 5 : 00PM (ET).
Position Summary :
Under the supervision of a Credentialing Supervisor / Manager, the Credentialing Specialist II is responsible for specific aspects of Credentialing and Re-credentialing processing for a managed care organization, adhering to the National Committee for Quality Assurance, State and Federal regulations.
They review, investigate, and process primary source verifications for facility, ancillary, medical and behavioral providers in a timely, efficient manner.
Minimum Requirements :
Diversity and Inclusion at Sentara
Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.
We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.
Our strategies focus on both structural inclusion, which looks at our organizational structures, processes, and practices;
as well as behavioral inclusion, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.
Please visit the link below to learn more about Sentara’s commitment to diversity and inclusion :
Sentara Overview
For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems.
That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers.
We offer a variety of amenities to our employees, including, but not limited to :
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace.
For information about our employee benefits, please visit : Benefits - Sentara (sentaracareers.com)
Join our team! We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!
Please Note : The yearly Flu Vaccination is required for employment.
Note : Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind.
Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave.
Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.
Job Summary Under the supervision of a Credentialing Supervisor / Manager, the Credentialing Specialist II is responsible for specific aspects of Credentialing and Re-credentialing processing for a managed care organization, adhering to the National Committee for Quality Assurance, State and Federal regulations.
They review, investigate, and process primary source verifications for facility, ancillary, medical and behavioral providers in a timely, efficient manner.
CPCS - Certified Provider Credentialing Specialist (Preferred) Requires thorough knowledge of managed care provider credentialing / re-credentialing principles, methods, regulations, and procedures normally acquired through a minimum of 2 years of directly related experience.
Acceptable areas demonstrating experience would be direct work experience with organizations such as a CVO, MCO, HMO or Hospital Based Credentialing (MSO).
Qualifications : ALD - Associate's Level Degree, HS - High School Grad or Equivalent (Required)Certified Provider Credentialing Specialist (CPCS) - Certification - Other / NationalRelated experience Skills Active Listening, Communication, Judgment and Decision Making, Reading Comprehension, Speaking, Technology / Computer, WritingSentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce.
Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.
gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission to improve health every day, this is a tobacco-free environment.
Last updated : 2024-05-16
Full Time
$46k-58k (estimate)
05/05/2024
08/02/2024
The job skills required for Credentialing specialist include Managed Care, Diversity and Inclusion, Quality Assurance, Flexibility, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Credentialing specialist positions, which can be used as a reference in future career path planning. As a Credentialing specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing specialist. You can explore the career advancement for a Credentialing specialist below and select your interested title to get hiring information.
If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.
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Quotes from people on Credentialing Specialist job description and responsibilities
A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.
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A credentialing specialist can have certificates that will prove useful to their field.
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Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
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Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.
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Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Credentialing Specialist jobs
Credentialing specialists can often find work with a high school diploma or the equivalent.
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Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.
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While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.
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Make Use Of Advanced Software For Monitoring.
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Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
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