Offer summary

Qualifications:

High School Diploma or equivalent required; some college preferred., Strong organizational skills and attention to detail., Proficient in Word, Excel, and Access with strong computer skills., Knowledge of clerical principles and strong telephone etiquette..

Key responsibilities:

Process credentialing and re-credentialing applications for health care providers.

Maintain and update credentialing information and provider files.

Establish professional relationships with providers and insurance contacts.

Track application statuses and ensure compliance with health information security.

Job description

Position Summary: Processes credentialing and re-credentialing applications and Credentialing Vendor requests for OBHG health care providers.

Position Responsibilities: Essential

Maintain credentialing information by reviewing, entering and following up on missing information.
Establish and maintain professional relationship with providers, insurance providers, client contacts and account service/credential personnel.
Submit and follow up on request for signatures in a timely manner.
Respond to credentialing requests.
Contact and respond to request to/from hospitals and health payers for verification of provider's credentials, ensuring credentialing and licensing processes are completed timely.
Responsible for the processing and preparation of the applications for insurance payer participation with the ability to manage multiple facilities'/payers' enrollment requirements, which includes non-application requests that are indicated by OBHG staff and/or facility/payer.
Track credentialing application statuses.
Maintains providers/practitioner files including maintenance of the OBHG provider database, individual CAQH profiles and providers rosters by identifying who may need updating or re credentialing and process accordingly.
Maintains and updates CRM, Mail and Utility Logs for provider's licensure, board certifications and certificate of insurance.
Escalate non-responsiveness of MD to Supervisor with documentation of request.
Meet required turnaround times and accuracy rates.
Ensure all Protected Health Information is kept in a secure location at all times and maintain Compliance by communicating credentialing request, status and issues to the Corporate Compliance Officer.
Participate in the Maternal Health Access Solutions committee as necessary.
Perform other duties as assigned by Payer Enrollment Manager and/or Management

Essential Skills/Credentials/Experience/Education

Knowledge of clerical principles and strong telephone etiquette
Strong organizational skills and attention to detail.
A minimum of a High School Diploma or equivalent is required; some college or equivalent experience is preferred.

Preferred Skills/Credentials/Experience/Education

Two-three years of clerical experience.
Strong computer skills, proficient in Word, Excel & Access.
Preferred understanding of medical terminology.
CPCS credentialing preferred.
College or equivalent experience is preferred.

Mental and Physical Demands (per ADA guidelines)

Physical Demands:

Sitting for long periods of Occupation requires this activity more than 66% of the time (2.6+ hrs/day)

Travel Demands:

May require occasional travel to corporate headquarters in Greenville, SC.

Hourly Compensation Range: $20.00 - $22.00 per hour

What We Offer - The Good Stuff:

A mission based company with an amazing company culture.
Paid time off & holidays so you can spend time with the people you love.
Medical, dental, and vision insurance for you and your loved ones.
Health Savings Account (with employer contribution) or Flexible Spending Account options.
Paid Parental Leave
Employer Paid Basic Life and AD&D Insurance.
Employer Paid Short- and Long-Term Disability.
Optional Short Term Disability Buy-up plan.
401(k) Savings Plan, with ROTH option.
Legal Plan.
Identity Theft Services.
Mental health support and resources.
Employee Referral program – join our team, bring your friends, and get paid.