Credentialing Specialist
Position Overview:
This role is responsible for facilitating all aspects of onboarding, credentialing, and compliance for clinical and field-based personnel. The Onboarding, Credentialing, and Compliance Specialist will organize, maintain, and verify all aspects of the process and maintain current files on clinical and field-based staff. Additionally, they will provide a positive customer service experience to team members, including clinical and field staff, and payors by being the point of contact and assisting them with related inquiries.Talent Client Service Manager (tCSM) Essential Functions:
The ideal candidate must be able to perform the following essential job functions with or without reasonable accommodations.
- Manage candidate applications and associated pre-hire requirements.
- Communicate regulations, policies, and procedures to team members, including clinical and field staff, as needed.
- Engage candidates and assist with setting schedules and expectations, enrolling them in required courses, and tracking completion of activities.
- Create applicable internal and external accounts, as needed.
- Assist clinical and field staff in applying/registering for certifications, licensure, etc., needed for credentialing.
- Obtain and review certifications, licenses, and any other required credentialing documents required to maintain up to date personnel files.
- Submit and follow up with payor credentialing applications via phone, email, or proprietary portals.
- Alert and enroll clinical and field staff, as needed, in required courses based on the payor, state, and federal regulations and track completion.
- Review documentation for accuracy and ensure compliance with Centria, payor, state, and federal mandates.
- Track clinical and field staff compliance and communicate to the appropriate individuals to ensure
receipt before expiration, update internal and external systems with compliance and credentialing documents. - Assist with audits from external and internal sources and ensure timely completion.
- Perform dormant employee follow-up and offboarding tasks, as needed, and in compliance with Centria guidelines.
Required Skills, Qualifications and Knowledge:
- Associates Degree required, Bachelor’s degree preferred
- 1 + years administrative or customer service experience.
- Data entry experience preferred
- Proficiency in PC software, especially spreadsheet programs;
- Effective communication skills, both written and verbal with internal and external stakeholders;
- Ability to build rapport with team members, including clinical and field staff, explain complicated information in an approachable and easily understood manner, effectively handle challenging phone conversations, and represent the Centria brand;
- Ability to organize, prioritize and handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks;
- Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business outcomes;
- Excellent interpersonal and listening skills;
- Demonstrated strong work ethic with attention to detail, accuracy, and quality;
- Established track record of generating error-free work.
- Ability to communicate effectively, both oral and written/
Working Conditions:
Centria’s office hours are Monday through Friday from 8:30am-6:00pm. Additional time may be required to complete above work or meet company objectives. Overtime is not aplanned part of this role; if required, overtime must be pre-approved by a leader in teh department.
Physical Requirements:
While performing the duties of this job, physical requirements such as bending, reaching, lifting, pushing, or pulling up to
30 pounds may be required. This role will require sitting most of the day as well as walking and standing periodically. This
role may require close visual acuity on computer screens or monitors and the ability to analyze data and figures on a
screen.
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. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position. Centria reserves the right to amend this job description at any time, with or without written notice.
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