What are the responsibilities and job description for the Credentialing Specialist position at Westbrook Health Services, Inc.?
Brief Description
Summary: Verifies and maintains the professional credentials of individuals, especially healthcare providers, to ensure they meet regulatory and organizational standards.
Essential Duties and Responsibilities: Other duties may be assigned to meet business needs
using computerized billing systems is preferred, but not required. Incumbent must also possess
basic math Skills. Must pass Criminal Investigation Background and DHHR background checks.
Physical Requirements: 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. Mobility
and ability to sit for long period of time, use a standard computer keyboard, calculator and telephone.
Ability to bend reach and lift up to 10 pounds are required in this position.
Requirements
Education and/or Experience: High School Diploma or GED; prior computer/PC experience
using computerized billing systems is preferred, but not required. Incumbent must also possess
basic math Skills. Must pass Criminal Investigation Background and DHHR background checks.
Physical Requirements: 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. Mobility
and ability to sit for long period of time, use a standard computer keyboard, calculator and telephone.
Summary
The professionals at Westbrook Health Services believe in promoting the well-being of individuals and families struggling with a wide range of challenges. Our staff meets the needs of over 7,000 people annually. Experienced and compassionate, we empower people to achieve wellness with the guidance of our knowledgeable and experienced staff.
Westbrook provides Equal Employment Opportunity to all employees and applicants. Employment decisions are made based upon an individual’s skills and qualifications without regard to race, color, creed, religion, sex, age, national origin, citizenship, disability as defined in the law, veteran status, sexual orientation, pregnancy and related conditions, genetic information, gender identity or any status or characteristic protected under applicable federal, state, or local laws. Westbrook also prohibits unlawful discrimination based upon the perception of those characteristics or any association with a person who is perceived to have any of those characteristics.
Discrimination based on any of these factors is totally inconsistent with our philosophy of doing business and will not be tolerated at any time.
Qualified individuals with bona fide disabilities, as the term “disability” is defined in the law, are entitled to reasonable accommodations in the application process and in their employment. Although Westbrook is responsible for providing reasonable accommodations, the responsibility for identifying whether accommodation is needed and what constitutes a reasonable accommodation is shared jointly by the employee and Westbrook.
Summary: Verifies and maintains the professional credentials of individuals, especially healthcare providers, to ensure they meet regulatory and organizational standards.
Essential Duties and Responsibilities: Other duties may be assigned to meet business needs
- Compile, process and maintain credentialing applications
- Enter, update and maintain accurate data in provider & agency databases
- Verifies education and licenses through source verification
- Monitor & professionals and agency records to ensure compliance with all regulatory and accrediting standards.
- Monitor license and credential expiration dates and advise staff on renewal procedures to prevent lapses.
- Respond to inquiries and provide information to requesting agencies or individuals as required by law
- Verify, upload and enter insurance policies into client benefit assignments as requested
- Comply with federal, state and company policies, procedures and regulations
- Maintains confidentiality of all information and complies with HIPAA regulations
- Demonstrates knowledge of and supports Westbrook Health Services mission, vision, values, policies and procedures, operating instructions, confidentiality standards and code of ethical behavior.
- Excellent attention to detail.
- Able to use basic office machines such as computer system, word processing, excel, calculators and fax machine.
- Able to communicate clearly and accurately with a variety of individuals in order to convey and received information effectively.
- Must work well in a team environment
- Work with staff, consumers and others in a professional, cooperative ethical respectful and effective manner.
- Ability to work with a diverse group of people
using computerized billing systems is preferred, but not required. Incumbent must also possess
basic math Skills. Must pass Criminal Investigation Background and DHHR background checks.
Physical Requirements: 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. Mobility
and ability to sit for long period of time, use a standard computer keyboard, calculator and telephone.
Ability to bend reach and lift up to 10 pounds are required in this position.
Requirements
Education and/or Experience: High School Diploma or GED; prior computer/PC experience
using computerized billing systems is preferred, but not required. Incumbent must also possess
basic math Skills. Must pass Criminal Investigation Background and DHHR background checks.
Physical Requirements: 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. Mobility
and ability to sit for long period of time, use a standard computer keyboard, calculator and telephone.
Summary
The professionals at Westbrook Health Services believe in promoting the well-being of individuals and families struggling with a wide range of challenges. Our staff meets the needs of over 7,000 people annually. Experienced and compassionate, we empower people to achieve wellness with the guidance of our knowledgeable and experienced staff.
Westbrook provides Equal Employment Opportunity to all employees and applicants. Employment decisions are made based upon an individual’s skills and qualifications without regard to race, color, creed, religion, sex, age, national origin, citizenship, disability as defined in the law, veteran status, sexual orientation, pregnancy and related conditions, genetic information, gender identity or any status or characteristic protected under applicable federal, state, or local laws. Westbrook also prohibits unlawful discrimination based upon the perception of those characteristics or any association with a person who is perceived to have any of those characteristics.
Discrimination based on any of these factors is totally inconsistent with our philosophy of doing business and will not be tolerated at any time.
Qualified individuals with bona fide disabilities, as the term “disability” is defined in the law, are entitled to reasonable accommodations in the application process and in their employment. Although Westbrook is responsible for providing reasonable accommodations, the responsibility for identifying whether accommodation is needed and what constitutes a reasonable accommodation is shared jointly by the employee and Westbrook.