What are the responsibilities and job description for the Credentialing Administrator position at Pediatrics Plus?
Job Details
Description
We are currently seeking a Credentialing Administrator to join our team of highly qualified professionals that share our vision of Empowering Children to Conquer their World! This role ensures company-wide credentialing while ensuring compliance with all applicable laws, rules and regulations.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
What we offer:
- Competitive Pay
- Paid Time Off
- Medical, Dental, & Vision Insurance
- State of the Art Facilities & Technology
What you will do:
- Maintains credentialing of all Therapy, Developmental Preschool, Management, and RISE.
- Implements and utilizes the HR database, including ways to improve efficiency by use of the database.
- Compiles and maintains current and accurate data for all providers in HRIS and deTASO.
- Maintain and update Council for Affordable Quality Healthcare (CAQH) online credentialing application for all providers quarterly.
- Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed.
- Maintain documentation and reporting regarding provider enrollments in process.
- Maintains copies of malpractice coverage, current state licenses, and any other required credentialing documents for all providers.
- Tracks license and certification expirations for all providers to ensure timely renewals and updates health plans accordingly.
- Ensures practice addresses are current with health plans.
- Maintains confidentiality of provider information.
- Updates job knowledge by some or all the following: participating in educational opportunities; reading professional publications; maintaining personal networks and/or participating in professional networks.
- Responds positively to feedback concerning job performance.
- Communicates any needs or concerns with administration.
- Upholds and incorporates the core values, vision, mission and philosophy of Pediatrics Plus into all job responsibilities.
- May perform other related and non-related duties, as assigned.
Qualifications
Minimum Requirements:
- High School Diploma required.
- Ability to communicate effectively and professionally with a wide variety of people.
- Strong organizational skills with attention to detail and accuracy.
- Basic computer skills which includes a working knowledge of keyboarding, database, word processing, spreadsheet, and Internet software.
- Ability to handle multiple tasks in a very busy environment. Ability to read and interpret documents such as safety rules, policies, and other company documents. Ability to write routine reports and correspondence. Ability to speak effectively before groups of employees or outside individuals.
- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
- Ability to maintain regular and punctual attendance.
- Ability to complete tasks in a timely manner.
While performing the duties of this job, the employee is frequently required to talk or hear. The employee is regularly required to walk; sit; use hands to finger, handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. The employee is required to maintain regular and punctual attendance. The employee is required to complete tasks in a timely manner.
We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
