Credentialing Specialist Job at Charter Oak Health Center Inc, Hartford, CT

Q1lBc2N3Q0hONmhBY1dlbC82U1psZHRzZEE9PQ==
  • Charter Oak Health Center Inc
  • Hartford, CT

Job Description

Job Description

Job Description

Description:

POSITION SUMMARY

Responsible for the credentialing of all clinical staff members, implementing necessary enrollment with commercial vendors, and performing other clerical tasks and special projects as needed.

Essential Position Duties

  1. Ensure provider credentialing applications are complete and accompanied with the appropriate requested documentation.
  2. Conduct verification of credentials for all licensed staff and contractual personnel including education, employment, National Practitioner Data Bank Query (NPDB), Office of Attorney General (OIG) Exclusion List, licenses, and American Medical Association (AMA) Physician Profile and/or Board Certification.
  3. Prepare and compile the necessary documentation and gather the appropriate signatures for initial appointment and reappointment of delineated privileges for presentation to the Staff Credentialing Committee.
  4. Ensure that the credentialing roster and provider carrier enrollment list are kept up to date on a daily basis.
  5. Coordinate and facilitate the new enrollment and maintenance of providers into Medicaid, Medicare, and commercial insurances.
  6. Send the updated provider carrier enrollment list to applicable staff on a weekly basis.
  7. Assist with the implementation and ongoing maintenance of the credentialing software.
  8. Maintain confidentiality of all credentialing data.
  9. Perform miscellaneous duties as required by management.
  10. Maintain appropriate attendance.

Compliance Responsibilities

  • Comply with applicable legal requirements, standards, policies and procedures including but not limited to those within the Compliance Process, Code of Conduct, HIPAA and Corporate Integrity Agreement (CIA).
  • Participate in required orientation and training programs, as required.
  • Report concerns and suspected incidences of non-compliance in accordance with COHC Compliance Reporting Process.
  • Cooperate with monitoring and audit functions and investigations.
  • Participate, as requested, in process improvement responsibilities.
Requirements:

POSITION QUALIFICATIONS

Core Competencies/Skill Sets

· Proficiency in Microsoft Office and Outlook is required.

· Excellent typing and interpersonal skills required.

· Strong organizational and excellent follow up skills.

· Strong communication skills both verbally and in writing.

· Ability to interact professionally and communicate with coworkers, providers and outside agencies.

Professional Experience/Educational Requirements

  • High school diploma required, an Associate’s degree desirable.
  • Minimum 1 -2 years credentialing and or privileging experience within a hospital or medical center environment is preferred.

Certification/Licensure

  • Credentialing Specialist Certification preferred

COVID-19 VACCINATION REQUIRMENTS:

COHC requires all new employees to be vaccinated against Covid-19 prior to starting employment with COHC unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.

Job Tags

Similar Jobs

Frontier Management

Activities and Lifestyle Assistant Job at Frontier Management

 ...consider working with one of our light, bright, and beautiful Assisted Living and Memory Care communities - where our residents are #...  ...members shine! Frontier Senior Living is seeking an outstanding Activities and Lifestyle Assistant to develop and promote a strong... 

elite personnel

Real Estate Administrative Assistant Job at elite personnel

 ...Weve partnered with a leading real estate firm in Bethesda, MD, and they are seeking a detail-oriented and highly organized Transaction Coordinator to join their dynamic team! to join their dynamic team! If you thrive in a fast-paced real estate environment and excel... 

GardaWorld Security Services U.S.

Surveillance Security Officer - Immediate Hire Job at GardaWorld Security Services U.S.

 ...Job Description: GardaWorld Security Services is Now Hiring a Surveillance Security Officer! Ready to suit up as a Surveillance Security Guard? What matters most about a role like this is your sharp eye, capturing every detail as you scan a series of screens... 

Tuxedo Den

Fashion Consultant / Stylist Job at Tuxedo Den

 ...Job Description Job Description We are seeking a Fashion Consultant / Stylist to become an integral part of our team! You will be responsible for selling products, merchandise, and services in a retail setting in order to drive company revenue. Our store is set up... 

Unifi

Airport Ramp Agent-Non Driving (American) - LIH PT Job at Unifi

 ...General information Job Title Airport Ramp Agent-Non Driving (American) - LIH PT Date Monday, February 17, 2025 State Hawaii City Lihue Base Pay Rate: $ 15.00 Full/Part Time Part Time Part Time...