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Delegated Credentialing Specialist- Greenway Plaza

Houston Galleria, TX

Posted: 00/00/1900 Industry: Accounting & Financial Job Number: 144777.10 Pay Rate: $80-90k
Client in Greenway Plaza area in need of Delegated Credentialing Specialist. Position is temp to hire and salary is$80-90k.This individual will assist the Credentialing and Contracting Department. The ideal candidate will have worked for a physician office, hospital, federal or commercial payer, be well versed in all aspects of physician credentialing, including policies and procedures. Exemplary organizational and customer service skills with attention to detail is a priority. The candidate must be able to meet time-sensitive deadlines and multi-task in a changing healthcare environment. The work environment is fast paced and requires detailed work and precision. Must have high school diploma or equivalent and 3-5 years of experience with delegated physician credentialing. Roles and Responsibilities: "Prepare credentialing information for Client's contracted health plans, including document review and credentialing file preparation "Perform primary source verifications "Prepare and present credentialing files for Credentialing Committee and Board of Directors "Maintain accurate database of physician credentialing information "Follow up with Client's payers to ensure timely receipt of provider payer effective dates "Interact with sub-delegated CVO to ensure accurate and timely information is received for the Physician Credentialing file per NCQA guidelines "Maintain policy and procedure and ongoing monitoring binders and files "Maintain a working knowledge & application of computer directories, folders and worksheets for filing and storingcompany data "File and maintain Credentialing Contract file documents "Answer and manage incoming customer service calls, including calls for the Center of Excellence Program "Field customer support calls

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