Processes credentialing and re-credentialing applications of practitioners, reviews application, prepares verification letters, track responses, follows-up for needed information. Conduct background investigations on practitioners including licensure, education and post-graduate clinical training, board certification, disciplinary actions and other professional sanctions, malpractice history, and peer assessment of current competence, in accordance with NCQA, Joint Commission and URAC credentialing standards and other established principles of legal documentation and confidentiality. Maintains credentialing database by entering accurate and up-to-date data for each applicant into the database. Responsible for the accuracy and integrity of the data entered. Assists credentialing staff with duties such as making copies, preparing mailings, attending staff meetings, preparing minutes, etc. Responsible for FCI Billing functions including distribution of funds on a weekly basis. Primary focus is participating in the completion of the tasks and assisting staff with complex tasks or problem area. Secondary task is to monitor completion of tasks by work group, including input into work assignments.
* College degree preferred. * Basic computer knowledge. * Ability to communicate effectively, both verbally and in writing. * Related and relevant experience or a demonstrated ability to perform the duties of the position may be considered in lieu of the academic requirements. * Medical terminology recommended. * Knowledge of ECHO, Word, Excel, and Access preferred. * Must be organized and be able to work quickly, independently, and with little supervision. * Two years experience in healthcare setting. * Related and relevant experience or a demonstrated ability to perform the duties of the position may be considered in lieu of the academic requirements. * High school diploma or equivalent. Coding certification within one year of employment.