East Liberty Family Health Care Center
  • Pittsburgh, PA, USA
  • $30,226.00 - $40,894.00
  • Salary
  • Full Time

Medical, Dental, Vision, Life Insurance, Retirement, Employee Assistance Program, Holiday pay, Paid sick/vacation, and supplemental benefit options


Seeking a full-time (40 hours per week) Credentialing Specialist to Initiate verification of practitioners education and experience through the use of on-line systems, written correspondence, telephone inquiries and printed reference guides and reports. Maintains current verification information in credentialing database/files.

Ensures consistent documentation and complete verification of practitioner credentials in accordance with Federal, State, Accreditation, Program and Regional requirements.

 

Job Responsibilities:

  • Review, complete and monitor application for provider credentialing
  • Contact medical facilities, licensing agencies and insurance carriers to complete credentialing and re-credentialing applications
  • Secure and maintain provider privileges to ELCHCC, hospitals and insurance carriers
  • Track new /acquisition providers for licensure, privileges and credentialing
  • Database maintenance: address changes, CAQH updates, and Carrier file maintenance.
  • Compliance with company policies and procedures, local, state and federal government regulations as well as HIPAA Guidelines
  • Verify competence, medical and/or professional education, residency, internships, fellowships, additional formal training, relevant board certifications, health care affiliations, work history, military experiences, professional references, licensure and certifications, DEA certificates, malpractice coverage and privileges the applicant is requesting Querying the National Practitioner Data Bank as appropriate
  • Organizing and maintaining credentials files in the medical staff office Present completed files to Medical Director  or Dental Director for approval; prepare file to go to board for final approval.

Familiar with HRSA and JCAHO standards, payer credentialing, the PA Medical Assistance credentialing system and PECOS.

Job Requirements:

  • Credentialing Specialist must have 1+ years of healthcare credentialing experience
  • Knowledge and understanding of credentialing and re-credentialing process
  • Credentialing Specialist must possess a strong proficiency with Microsoft Office Suite (Word/Excel/Outlook/PowerPoint)
  • Must possess the ability to type 40+WPM (alphanumeric & 10-key typing)
  • Attention to detail
  • Knowledge of HRSA and JCAHO Standards
  • Knowledge of payer credentialing
  • Knowledge of PA Medical Assistance credentialing system
  • Familiar with the PECOS system

 

Compensation: $30,226.00-$40,894.00

Commensurate with experience.

 

Benefits: At East Liberty Family Health Care Center, we offer an exceptional benefit package including Medical, Dental, Vision, Life Insurance, Retirement, Employee Assistance Program, Holiday pay, Paid sick/vacation, and numerous supplemental benefit options.

East Liberty Family Heath Care Center does not discriminate on the basis of race, sex, color, creed, religion, disability, veteran status, genetic information, pregnancy, or national origin in any manner. East Liberty Family Health care Center is an Equal Opportunity Employer. EOE/AA/M/D/F/H/V

 

East Liberty Family Health Care Center
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