Credentialing Specialist

  • Location
    Oklahoma City, Oklahoma
  • Category
    Administration
  • Job reference:
    US_EN_5_844859_2830663
  • Job type
    Contract/Temp to Hire

Accounting Principals is currently seeking a Credentialing Specialist for a full-time position at a well-established medical company in Oklahoma City, OK.  This is a contract-to-hire role that will focus primarily on coordinating providers, facilities and allied health professional initial appointments and reappointments, evaluate timeliness reports and complete queries to support the functions of the department and maintain current knowledge of applicable State and NCQA CR Standards.

This role will involve processig of credentialling applications and verify there will be no kickbacks.    Candidates will need extreme high attention to detail with the importance of the credentialing being done accurately and timely.  Ideal candidate will have at least 2 years of background in a credentialing background.

 

ESSENTIAL JOB FUNCTIONS:                                                                                     

  • Processes credentialing applications checking for completeness and accuracy. 
  • Examines researches, enters data, setup files and gathers all information necessary to process application.
  • Obtains primary source verification of competencies including board certifications, health facilities affiliations, licensure, certifications, DEA, State certificates, and malpractice coverage.
  • Queries and processes primary source verification and accreditation information including NPDB, OIG, SAM, and Medicare Opt Out.
  • Communicates with providers and provides excellent customer service.
  • Prepares credentialing files and submits practitioner information meeting all timelines.
  • Maintains and updates credentialing database for practitioners, providers and facilities.
  • Maintains communication with appropriate practitioners to ensure records are up to date.
  • Handles expirables and ensuring required documents are received and verifications completed within established deadlines.
  • Notifies providers in writing of Credentialing decisions and renewal dates.
  •  

    EDUCATION AND EXPERIENCE:                                                                                                                  

  • High School diploma or equivalent (required)
  • Associate degree in Business Admin or Health Care Admin (preferred)
  • 1-2 years of credentialing experience
  •  

    KNOWLEDGE, SKILLS AND ABILITIES:                                                                                                      

  • Excellent oral and written communication skills
  • Strong attention to detail with critical thinking skills  
  • Proficient in computer and applications. Experience in Word, Excel, Intellisoft, Adobe Reader, Outlook preferred.
  • Knowledge of credentialing forms and required documentation for application processing.
  •  

    TRAVEL:                                                                                                                                                          

    Some external travel may be required and would therefore expose this employee to average traffic hazards

    EMPLOYMENT TYPE: Full-time, Temp to Hire

     

    COMPENSATION:

    $16-$20 per hour USD

     

    Work Hours: 8:00 AM – 5:00 PM, 40 hours per week

     

    If interested in this Credentialing Specialist role, please send Word resume to okc@accountingprincipals.com or apply directly to www.accountingprincipals.com. 



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