What are the responsibilities and job description for the Credentialing Representative 2 (REMOTE) position at Franciscan Missionaries of Our Lady Health System?
The Credentialing Representative 2 is responsible for credentialing compliance with each entity's Medical Staff bylaws, rules and regulations, policies and procedures, The Joint Commission, NCQA, and federal and state regulations, as applicable to the customer. The Credentials Specialist is responsible for analysis of credentialing files, membership requests and renewals for all facilities where providers practice on behalf of FMOL, reappointment activities, malpractice enrollment and renewal, management and maintenance of supervision/collaboration status of Allied Health Professionals with respective state boards and payer enrollment. Relies on education, critical thinking skills, and judgment to accomplish job. Ability to process and manage applications. Works under general supervision. Creativity and some latitude is expected to complete responsibilities.
Requirements:
- 4 years experience in a healthcare entity that includes payor interactions and/or credentialing plus 1 year credentialing experience performing all the functions of the credentialing process (undergrad degree may substitute for 4 years' experience requirement)
- High school or equivalent
- Microsoft Applications, Computer Literacy, Data Entry, Internet Searching Abilities
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