CREDENTIALING CLERK II (2547)

Job Summary:

Provides administrative support to the Credentialing staff. With direction, oversight, and assistance from senior team members, the incumbent is responsible for the accuracy and integrity of the credentialing database systems and related applications. Develops, and distributes reports as needed.

Responsibilities:

• Entering and maintaining provider databases – EZ-Cap, IntelliCred, ePayor (symplr) and CAQH portal (Council for Affordable Quality Healthcare).
• Prepares files and maintains electronic provider files.
• Prepares credential files for completion and presentation.
• Gathers credentials and re-credentialing materials for contracted providers.
• Assists Credentialing Manager in the monthly reporting to healthcare organizations and other reporting as needed.
• Performs credentials verifications as needed.
• Assists the Contracts team in making outbound calls as needed.
• Problem-solves and assists in resolution of data issues.
• Maintains strictest confidentiality.
• Performs related duties consistent with the scope and intent of the position.
• Regular attendance.
• Travel as required.

Other Functions

• Enforces Company policies and safety procedures.
• Regularly updates job knowledge by participating in educational opportunities, reading professional publications, maintaining professional networks, and participating in professional organizations.
• Maintain IPA, Health Plan compliance standards.

Competencies

• Two years of experience in the medical administration industry.
• High Volume Data Entry Experience required.
• Credentialing and Medi-Cal experience preferred.
• Excellent communication skills, including both oral and written.
• Excellent active listening and critical thinking skills.
• Ability to solve mid-level problems with minimal supervision.
• Ability to demonstrate professionalism, confidence, and sincerity while quickly and positively engaging providers.
• Ability to multi-task, exercise excellent time management, and meet multiple deadlines.
• Ability to provide and receive constructive job and/or industry related feedback.
• Ability to maintain confidentiality and appropriately share information on a need-to-know basis.
• Ability to consistently deliver excellent customer service.
• Excellent attention to detail and ability to document information accurately.
• Ability to work in a dynamic, fast-paced team environment and achieve objectives effectively and positively.
• Demonstrate commitment to the organization’s mission.
• Must have mid-level skills in Microsoft software (Word, Excel, PowerPoint).
• Must have the ability to quickly learn and use new software tools.
• Must have mid-level skills using e-mail applications.
• Self-motivated with strong organizational, multi-tasking, planning, and follow up skills.
• Ability to work independently as well as in a team environment.
• Ability to present self in a professional manner and represent the Company image.

Education and Licensure

• High School Diploma or GED minimum requirement.

Travel

• The incumbent may travel up to 5% of the time.

Work Environment

This job operates in a professional office environment. This role routinely uses office equipment such as computers, phones, photocopiers, scanners and filing cabinets.

Salary : $21 - $23