Credentialing Administrator
Credentialing Administrator
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
Please be advised if you are viewing this position on Indeed that the salary rate/range set forth herein was provided by Indeed. Concentras market specific rate/range will be provided during the interview process.
Primary responsibilities include but are not limited to day-to-day support for the Contracting and Credentialing teams including launching of team workflows in the IntelliCred database; manage and track DOT and APC/ATC certification and compliancy; facility credentialing for Group Health payers; tracking of group health payer agreements/contracts for executive review/signatures; allocating and submitting expenses for internal credentialing verification charges.
Responsibilities
Serve as support for maintaining and tracking DOT certifications for all physicians nurse practitioners and physician assistants. Research/validate DOT certification and practice profiles via the National Registry of Certified Medical Examiners (NRCME) website. Notification of DOT certification and practice profile status is communicated to the field EAs and tracked for Concentra compliancy through the IntelliCred database
Serve as support for maintaining and tracking all APC/ATC agreements for compliancy. Submits written request to field EAs for APC/ATC agreements for all new hire annual/biennial renewals and supervising physician changes of Nurse Practitioners Physician Assistants and Athletic Trainers. Completion of APC agreement requests are tracked and monitored for compliancy through the IntelliCred database
Facilitate maintain and track facility credentialing applications for Urgent Care Physical Therapy Primary Care and Work Comp payers. Includes completion of simple to complex credentialing applications with supporting documents such as local state and federal licensures CLIA
certificates center assessment and services offered questionnaires. Credentialing activities are maintained and tracked in the IntelliCred database through various workflows
Act as the primary liaison to secure needed facility licensures by working with internal licensing department clinical and operational leaders.
Conduct internal audits such as facility rosters and various IntelliCred database validations to ensure data integrity
Launching workflows in the IntelliCred system for Medicare Group Health and Quality Control and Administration teams for new hires terms location updates for clinician Medicare enrollment external payer credentialing needs APC Collaborative Agreements and DOT certification
compliancy
Participate in acquisition activities for the department to include but not limited to launching workflows for all teams updating all internal facility rosters and IntelliCred Group records
Maintain all departmental administrative tasks such as office supplies incoming/outgoing mail Fed Ex department contact lists etc.
Create and maintain internal Facility Listings on shared drive and Groups/Locations in database to include facility demographics NPIs legal entity TIN Medicare PTAN and billing information utilized by the department and for external Group Health payer needs. Prepare various reports such as custom facility listings and provider rosters as requested for internal and external clients
Track contracts for review and signature by executive leaders. Maintain all Group Health payer contract files via electronic and hard-copy file system
Reconciliation for Internal Credentialing verification charges. Obtain receipts for each transaction validate and allocate the correct billing string for biweekly submission through the Concur expense reporting system
This job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this job. Duties responsibilities and activities may change at any time with or without notice.
Qualifications
Education Level: High School Diploma or GED
Major:
Degree must be from an accredited college or university.
Education Details:
A college degree in related field or equivalent work experience.
Job-Related Experience
Customarily has at least the following experience: 2 years
Customarily has at least 2 years of administrative skills experience
Moderate to advanced Excel skills
Job-Related Skills/Competencies
Concentra Core Competencies of Service Mentality Attention to Detail Sense of Urgency Initiative and Flexibility
Ability to make decisions or solve problems by using logic to identify key facts explore alternatives and propose quality solutions
Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in
accordance with federal and state laws and company policies
Ability to accurately type
Detail oriented and highly organized
Microsoft Office Suite
Excellent verbal and written communication skills
Ability to utilize all proprietary Concentra software programs
Ability to work independently within company guidelines and policies
Ability to effectively present information and respond to questions from managers clients and
customers
Ability to speak effectively in one-on-one situations
Ability to read and comprehend standardized instructions short correspondence and memos
Ability to effectively present information in one-on-one situations to other employees providers
and clients
Ability to solve practical problems and deal with a variety of concrete variables in situations where
only limited standardization exists
Ability to apply commonsense understanding to carry-out instructions furnished in written oral or
diagram form
Basic understanding of office equipment (copier scanner fax phone)
Additional Data
Employee Benefits
- 401(k) Retirement Plan with Employer Match
- Medical Vision Prescription Telehealth & Dental Plans
- Life & Disability Insurance
- Paid Time Off
- Colleague Referral Bonus Program
- Tuition Reimbursement
- Commuter Benefits
- Dependent Care Spending Account
- Employee Discounts
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. Please contact us torequest accommodation if required.
*This job requires access to confidential and sensitive information requiring ongoing discretion and secure information management*
Concentra is an Equal Opportunity Employerincluding disability/veterans
Required Experience:
Unclear Seniority
Employment Type
Unclear
