What are the responsibilities and job description for the Credentialing Specialist position at Empath Health?
Empath Health is currently seeking a Credentialing Specialist to join our team.
Responsible for all aspects of the assigned organization’s credentialing, re-credentialing and privileging processes for all medical providers who provide patient care. The Credentialing Specialist will ensure providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities. In addition, the Credentialing Specialist will maintain up to date data for each provider and ensure timely renewal of licenses and certifications, as well as maintain payer enrollment for providers and the assigned Empath Health organizations.
Additionally, responsible for maintaining all contracted vendor credentialing requirements, for all vendors that serve patient’s or participants, for all assigned programs within Empath’s continuum of care.
JOB DUTIES/RESPONSIBILITIES:
- Compiles and maintains current and accurate data for all employed or contracted clinical providers.
- Completes clinical provider credentialing and re-credentialing applications; monitors applications and follows up as needed.
- Tracks and maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Collaborate with those responsible for contract management to assure all credentialing requirements are met.
- Completes payor enrollment credentialing and re-credentialing applications; monitors and follows up as needed, creates provider rosters and maintains providers and organization in payor online portal
- Maintains knowledge of current accreditation and regulatory requirements for credentialing providers.
- Creates and maintains provider credentialing databases and systems.
- Provides credentialing verification for all Vendors contracting to provide patient care for all programs including but not limited to, Hospice, PACE, EPIC, Palliative, Home Health, Medical Services, etc.
- Collaborates with Physician Services to provide support in obtaining and maintaining hospital privileges for Empath medical providers.
- Works closely with finance staff to identify and resolve any issues related to provider credentialing.
- Performs other duties as requested.
LOCATION:
This position will be based out of an Empath Health office and will require occasional travel to other Empath Health offices.
POSITION QUALIFICATIONS/REQUIREMENTS:
- Education and/or Experience: Associate’s degree (A.A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.
- Minimum three years of relevant credentialing experience preferred.
- Certified Provider Credentialing Specialist (CPCS) preferred; active pursuit is acceptable also.
- Strong computer skills with willingness to learn new systems. Advanced competence in Word, Excel, and PowerPoint required.
- Demonstrated accuracy, dependability, and orientation to detail
- Excellent interpersonal, verbal and written communication skills.
- Ability to research and analyze data.
- Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
- Valid Driver's license and automobile insurance.
Empath Health values diversity as it strengthens our community and care. We embrace the diversity of cultures, thoughts, beliefs and traditions of our employees, volunteers and people we are honored to serve across our network. Our diverse staff reflects our community and each day, we work to be respectful, sensitive and competent with each other and those in our care. In every journey, we are dedicated to achieving comfort, dignity and exceptional care. Those of all backgrounds are welcome and encouraged to apply with us or seek our care and services.
Our commitment to patient, client, staff and volunteer safety is a cornerstone of a High Reliability Organization with a focus on zero harm. Participation in the seasonal influenza program is a condition of employment and a requirement for all Empath Health employees.
Providing compassionate, full life care is an honor we take seriously at Empath Health. Join our team and make a positive impact in the community!
