Billing and Credentialing Coordinator

Job Summary: The Credentialing Specialist will maintain high standards of accountability and operate on the principles of a High Reliability Organization in an effort to achieve safety, quality, and efficiency goals. This individual acquires and maintains relevant compliance documentation for Healthcare Provider candidates on assignment with client facilities by partnering with internal sales and clinical teams, creating urgency with candidates and reinforcing Joint Commission, federal, state and AMN mandates in order to achieve compliance for on-time start date ultimately impacting fill rate, market share and revenue.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Review healthcare providers’ submitted requirements including licensure, certifications, screens and other critical documents using the data platform system to determine healthcare provider (HP) document status versus requirements needed for specific assignment in order to pursue outstanding requirements.
• Communicate timely updates of HP document status with all internal stakeholders via the data platform system, email, phone, etc. to facilitate a team approach to gathering all required documents.
• Create urgency with healthcare providers via email and phone, to encourage timely and accurate document submission by establishing target dates and monitoring document submission progress in order to deliver comprehensive documentation to the client facility for an on-time assignment start date.
• Coordinate response to assigned client regulatory audits, TJC/TWSM/NCQA documentation, and other requests by client facilities by completing the requests with accuracy and within the established/provided timelines.
• Coordinate with 3rd party vendors to determine appropriate dates, times and locations for HP candidates to complete necessary compliance steps including drug screens, background checks, immunizations, etc.
• Facilitate quick book (QB) process for assigned facilities by taking lead role to collaborate with Account Managers, Recruiters and Housing department in order to determine reasonable start dates.
• Collaborate with Contracts Credentialing Analyst to review all incoming new client contracts or contract revisions for Credentialing requirements, for assigned facilities in order to identify unique requirements.
• Negotiate with client facility to reconsider unusual or uncustomary requirements by emphasizing the value and experience of Quality Services Department with client facilities in order to minimize disruption of placements and optimize fill rate.
• Consult clients on Credentialing best practices by making recommendations on requirements expectations and realistic start dates to streamline submission and placement processes in order to increase fill rate of qualified HPs.
• Maintain up-to-date and accurate facility database including updated contact information, new requirements and client correspondence by following up regularly with clients in order to optimize service coverage and prevent gaps in service delivery.
• Research new requirements (by The Joint Commission, OSHA, and others) that may impact the industry in order to present proposals to leadership that clarify appropriate action plans that will address the requirements with least resources and expense.
• Other duties as required.

EDUCATION AND EXPERIENCE REQUIREMENTS

• 4 years customer service experience or equivalent combination of education and experience
• 1 to 3 years previous experience in hospital or mental health clinical setting
• Leadership or supervisory experience

KNOWLEDGE, SKILLS, ABILITIES & WORK HABIT REQUIREMENTS

• Communication: Direct, concise. Keeps people informed. Listens effectively to others.
• Teamwork: Effective at working in team situations.
• Initiative: Originates action. Finds appropriate and effective ways to get things done.
• Quality: Promotes continuous improvement.
• Customer Responsiveness: Responds timely and well to internal and external customer needs.
• Analytical Thinking: Attention to detail over sustained periods of time with ability to analyze data and recognize trends. Ability to organize, evaluate, and address program operational data and information.
• Dependability: Counted on to follow through on commitments; at work each day on time; work completed timely.
• Independence: Receives no instruction on routine work with general instruction on new assignments.
• Aptitude: Ability to comprehend and apply new ideas, processes, procedures, or training.
• Organizational Awareness: Understands the culture of the organization and the interests and concerns of various group.
• Decision Impact: Understands the authority of this position and financial impact to the organization.
• Sensitive Information: Exposure to highly confidential information. Must maintain the highest level of discretion at all times.
• Technology: Very comfortable with technology systems and applications. Must maintain a valid drivers’ license and a clean driving record.
• Advocacy: Exhibits a passion for serving people and consistently advocates for clients and their families.

AGENCY REQUIREMENTS

• Completes 100% of mandatory trainings.
• Documents all unusual incidents for risk management. Follows policies and procedures of the agency.
• Maintains good attendance.
• Maintains confidentiality.

Equal Opportunity Employer/Non-discrimination in Services: OMNI Health Services, Inc. hiring and advancement practices, in accordance with Federal and State Law, prohibit discrimination based upon Age, Race, Creed, Color, National Origin/Ancestry, Sexual Orientation, Sex, or Handicap.

Job Type: Full-time

Pay: From $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: One location

Salary : $20 - $-1