Full-time
Posted 5 days ago
Job description
QUALIFICATIONS
- Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors, and the public and be capable of establishing good working relationships with both internal and external customers.
- Some knowledge of insurance billing and hospital credentialing is a plus.
- Knowledge of the credentialing process is a plus but not required
- Knowledge of credentialing timelines and regulations is a plus but not required.
- Minimum of three to four years of experience in healthcare.
- High school diploma/GED or equivalent working knowledge preferred.
ESSENTIAL FUNCTIONS
- Reviews and Re-Attest all provider's CAQH profiles.
- Maintain billing insurance grid, provider insurance grid, and each physician’s spreadsheet up to date on current insurance changes.
- Has knowledge of Employee Handbook content along with established policies and procedures.
- Relies on instructions and pre-established guidelines to perform the functions of the job.
- Assists the Credentialing Supervisor and Credentialing Specialist in their job responsibilities/duties when necessary.
The Credentialing Assistant is responsible for reviewing the Payer Credentialing status for all new providers, maintain all rosters, updating CAQH provider profiles, and more.
Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
#HOP
Frequently asked questions
Q: What skills or qualities help someone succeed as a Credentialing Assistant?
A: To succeed as a Credentialing Assistant, key technical skills include proficiency in electronic health record (EHR) systems, knowledge of medical terminology, and familiarity with credentialing software and regulatory compliance guidelines. Soft skills such as strong organizational and time management abilities, effective communication and interpersonal skills, and attention to detail are also crucial for success in this role. By possessing these technical and soft skills, Credentialing Assistants can efficiently manage credentialing processes, maintain accurate records, and provide excellent support to healthcare providers, ultimately contributing to their career growth and effectiveness in the role.
Q: What is the career path for a Credentialing Assistant?
A: A Credentialing Assistant's typical career progression involves starting as an entry-level Assistant, where they verify and process provider credentials, then advancing to a mid-level Coordinator role, overseeing credentialing operations and managing staff. As they gain experience, they can move into senior roles such as a Director of Credentialing, overseeing departmental strategy and implementing process improvements. Key opportunities for skill development include learning healthcare regulations, developing strong communication and project management skills, and staying up-to-date with industry standards and best practices.
