What are the responsibilities and job description for the Credentialing Account Specialist position at 3WON, LLC?
POSITION SUMMARY
Responsible for processing provider credentialing applications based upon federal, state, accreditation, and client requirements. Responsible for the accuracy and integrity of the credentialing database system and related applications. Works under the supervision of the Credentialing Manager.
ESSENTIAL FUNCTIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Essential Functions:
- Reviews practitioner applications and accompanying documents, ensuring applicant eligibility.
- Performs all appropriate primary source verifications of all components of the application file.
- Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
- Prepares credentials file for completion and presentation to client, ensuring file completion within time periods specified.
- Interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
- Utilizes and processes files through the credentialing database
- Performs miscellaneous job-related duties as assigned.
POSITION QUALIFICATIONS
Competencies:
- Ability to communicate effectively, both orally and in writing.
- Ability to manage a large volume, fast paced environment
- Knowledge of medical credentialing and privileging procedures and standards.
- Ability to work independently.
- Must have strong self discipline and motivation to work in a virtual environment
- Ability to use independent judgment to manage and impart confidential information.
- Database management skills including querying, reporting, and document generation.
- Ability to make administrative/procedural decisions and judgments.
SKILLS & ABILITIES
Education: High school diploma or GED
Experience: At least 3 years of experience directly related to medical provider credentialing in a hospital, managed care, or medical practice environment
Computer Skills: Working knowledge of Microsoft office and general database knowledge
Certificates & Licenses: Certification/Licensure NAMSS Certification as a Certified Provider Credentials Specialist (CPCS), preferred or able to obtain within 24 months of employment