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Credentialing Specialist at Professional Performance Development Group

Posted in Other 30+ days ago.

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Location: San Antonio, Texas





Job Description:
Professional Performance Development Group, Inc. is currently looking to hire a Credentialing Specialist to work in our Corporate Office. This position has a great deal of challenges and requires an individual to be in a constant learning mode. The Credentialing Specialist assists the Human Resource Administrators and Human Resource Specialists with day-to-day human resource and credentialing functions and duties with a high degree of accuracy, organization, diligence, and resourcefulness.

We are an award-winning and industry-recognized government contractor providing medical and healthcare, technical, and professional support services and solution in 45 states.
Job Requirements
  1. Human Resource and credentialing experience preferred.
  2. Human Resource or Business Administration degree, or five (5) years' experience in the fields of human resources or credentialing.
  3. Demonstrates computer skills to include use of MS Word and Excel.
  4. Must have good work ethic and integrity.
  5. Dependability and ability to perform work with minimum supervision.
  6. Excellent personal skills.
  7. Problem solving skills.
  8. Passionate about work.

Credentialing Specialist Duties:
  1. Performing and documenting licensure updates as applicable.
  2. Performing primary source verification of license, board certification, DEA/CDS certificates, education and training, Medicare/Medicaid sanctions, hospital privileges, malpractice history, insurance coverage, and NPDB/database queries.
  3. Updating provider information and entering malpractice coverage limits into applicable database system as appropriate.
  4. Documenting provider credentialing verification in checklist format; tracking expiration dates to ensure currency at time of Credentialing Committee decision.
  5. Working productively with provider offices, hospitals and other provider organizations to obtain documentation pertinent to timely completion of credentialing process.
  6. Maintaining current knowledge of credentialing procedures and applicable management information system changes.
  7. Coordinating with staff to receive missing credentialing information from non-compliant providers.
  8. Reviewing and evaluating changes in processing procedures.
  9. Responsible for setting up New Health Clinic accounts for medical requirements of contract and coordinating appointments with candidate.
  10. Apply Occupational Health protocols to control cost
  11. Other duties as assigned.

For more details contact Elizabeth Fernandez at 210-253-3823.