Credentialing Specialist at Parallon in Orange Park, Florida

Job Description:

DESCRIPTION SHIFT: Work From Home

SCHEDULE: Full-time

Do you want to be a part of a family and not just another employee? Are you looking for a work environment where diversity and inclusion thrive? Submit your application today and find out what it truly means to be a part of a team.

At HCA Healthcare, you have options. You can choose from a variety of benefits to create a customizable plan. You have the ability to enroll in several medical coverage plans including vision and dental. You can even select additional a la carte benefits to meet all your needs. Enroll in our Employee Stock Purchase Plan (ESPP), 401(k), flex spending accounts for medical and childcare needs, and participate in our tuition reimbursement program.

HCA Healthcare is dedicated to the growth and development of our colleagues. We will provide you the tools and resources you need to succeed in our organization. We are currently looking for an ambitious Credentialing Specialist to help us reach our goals. Unlock your potential here!

As a Credentialing Specialist, you will be responsible for supporting the development and implementation of the Credentialing Processing Center policies and procedures. This will include, but not be limited to responsibility for credentialing new and established health care providers, and maintenance of information to include primary source verification, follow up, data collection, data entry, and document review. Excellent communication and relationship building skills are required. Will be expected to assist the Manager and Director with other tasks/projects as requested.

What you will do in this role:

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Subject Matter Expert on Credentialing Processing Center policies, procedures and systems.
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Perform Data Integrity, Specialist Review and/or Compliance Review functions including record preparation, final review and flag assignment based on established CPC requirements.
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Maintain high quality, timely and accurate credentialing processes of medical and allied healthcare providers per CPC policy and procedures
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Proactively identify appropriate verification elements in accordance with CPC policy and procedures and as evidenced by QA
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Assure correct verifications are obtained based on specific provider's data and CPC policy and procedures, including but not limited to: state license(s), Federal and State DEA(s), board certification, education, and peer references.
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Monitor collection of all information received, follow up on missing items and/or incomplete forms per CPC policy and procedures; submit follow‐ up requests for verifications as needed.
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Identify and evaluate potential flags and work in collaboration with the provider and MSO to document and resolve any potential issues and/or elevations and document in Cactus.
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Participate in policy development and deployment and CPC Audits.
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Advise Manager and/or Director of questionable information received and elevate any issues identified during the processes.
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Maintain all credentials records ensuring that all correspondence in the credentialing and reappointment process is accurately scanned and saved and are within required timeframes.
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Maintain compliance with all policy and procedures, Federal and State regulatory and accrediting agencies as required.

QUALIFICATIONS

EDUCATION

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Associate's degree or an equivalent combination of education and experience required.
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Bachelor's Degree preferred.

EXPERIENCE

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Minimum two years' experience in healthcare credentialing (i.e., healthcare facility, managed care setting, credentials verification organization, or Medical Staff Office) with one year as a specialist within the Parallon Credentialing Processing Center required.
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Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance preferred
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Completion of credentialing knowledge assessment and post Cactus training testing of 90% or greater.
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Successful completion of Credentialing 100, 101 and 201
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NAMSS certified at CPCS level preferred, or a commitment to pursue certification within one year

Parallon is an INDUSTRY LEADER in revenue cycle services. We partner with over 650 hospitals and 2,400 physician practices nation-wide. Our parent company, HCA Healthcare, has been consistently named a WORLD'S MOST ETHICAL COMPANY by Ethisphere and is ranked in the Fortune 100.

We are a family 270,000 strong! Our Talent Acquisition team is reviewing applications immediately. Highly qualified candidates will be promptly contacted by our hiring managers for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

NOTICE

Our Company's recruiters are here to help unlock the next possibility within your career and we take your candidate experience very seriously. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Gmail or Yahoo Mail. If you feel suspicious of a job posting or job-related email, let us know by clicking here.

For questions about your job application or this site please contact HCAhrAnswers at 1-844-422-5627 option 1.

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