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Lead, Credential Examiner (Remote)
Company | American Specialty Health |
Address | United States |
Employment type | PART_TIME |
Salary | |
Category | Wellness and Fitness Services |
Expires | 2023-06-12 |
Posted at | 1 year ago |
Description
- Handle complex credentialing issues and priority files as determined by management.
- Monitor the credentialing process and time frames to ensure performance standards are met.
- Work closely with staff to identify challenges in meeting performance and production standards.
- Handle provider escalation calls and assessing if further escalation to management is required.
- Responsible for complying with the process in handling provider files with Corrective Action Plans.
- Communicate with management any barriers for further support.
- Complete admin review within 48 hours from the time the credentialing examiner closes the file.
- Coaching feedback for credentials examiners on errors made.
- Prepare weekly meeting agenda’s and distribute team meeting minutes.
- Must complete regulatory trainings within the timeframe provided by department manager.
- Track staff production and errors and prepare reports for supervisor.
- Educate credentials examiners regarding new policies and procedures.
- Coordinating use of shared inbox for credentialing and recredentialing support.
- Support supervisor and staff, as necessary.
- Minimum of complete admin review of 35 files per day.
- Research credentialing issues by interfacing with supervisor, manager, or other departments.
- Responsible to obtain information to credential new applicants and recredential participating practitioners according to department standards.
- Responsible to complete credentialing or recredentialing files that require special attention and expertise.
- Train new credentials examiners and ensure training materials are up to date.
- Assist with file assignment and other administrative tasks as needed.
- Communicate complex issues with providers by mail, fax, or phone to answer questions and obtain information to update provider files.
- Enter data and perform research functions in Promis/PCT/SharePoint to complete each portion of the credentialing process within predetermined timelines.
- Support credentialing team by answering questions and assisting with the resolution of issues.
- Abide by departmental work from home expectations.
- Proficient in MS Office, including experience with Excel.
- A minimum of 1 year of Credentials Examiner experience.
- Experience in all specialties both in credentialing and recredentialing.
- High School diploma required.
- Typing speed must be between 45-50 wpm.
- Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
- Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
- Ability to effectively organize, prioritize, multi-task and manage time.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- Ability to exercise strict confidentiality in all matters.
- Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
- Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
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