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Do you want to be a part of a family and not just another employee? Are you looking for a work environment where diversity and inclusion thrive? Submit your application today and find out what it truly means to be a part of a team.
At HCA Healthcare, you have options. You can choose from a variety of benefits to create a customizable plan. You have the ability to enroll in several medical coverage plans including vision and dental. You can even select additional a la carte benefits to meet all your needs. Enroll in our Employee Stock Purchase Plan (ESPP), 401k, flex spending accounts for medical and childcare needs, and participate in our tuition reimbursement and student loan repayment programs.
HCA Healthcare is dedicated to the growth and development of our colleagues. We will provide you the tools and resources you need to succeed in our organization. We are currently looking for an ambitious Credentialing Specialist to help us reach our goals. Unlock your potential here!
As a Credentialing Specialist, you will be responsible for supporting the development and implementation of the Credentialing Processing Center policies and procedures. This will include, but not be limited to responsibility for credentialing new and established health care providers, and maintenance of information to include primary source verification, follow up, data collection, data entry, and document review. Excellent communication and relationship building skills are required. Will be expected to assist the Manager and Director with other tasks/projects as requested. All activities will be performed for select HCA hospitals within established levels. Compliance with HMA policy and procedure, Federal and State regulatory and accrediting agencies is required.
What you will do in this role:
• Maintain high quality, timely and accurate credentialing processes of medical and allied healthcare professionals per CPC policy and procedure
• Assist in the credentialing process by entering/logging/scanning information into credentialing system for initial, updated, add on applications and maintenance processes
• Acts as liaison with MSO as point person for completing and ensuring compliance and delivery of required information to clients in a timely manner
• Process and maintain credentialing and re-credentialing in accordance with CPC policy and procedure, Joint Commission standards, State and Federal Regulatory regulations.
This will include but not limited to the following verifications:
National Practitioner Data Bank OIG/GSA for Medicare/Medicaid exemption
DEA Verification Licensure
Board Certification Training verified. Residency/ Fellowship
Peer Recommendation Professional Schooling Verified
• Ensure that all credentials files are current and complete pursuant to expiration date of medical licenses, board certification, professional-liability insurance coverage, DEA and other pertinent information, per CPC policy and procedure
• Monitor collection of all information received; follow up on missing items and/or incomplete forms per CPC policy and procedure, submit follow up requests for verifications as needed
• Identifies and evaluates potential red flags and works in collaboration with practitioner to document the issue and physician response
• Advise Manager and/or Director of questionable information received and any issues identified during the processes
• Submit closed files for audit/final review and secure missing items as identified by audit/final review
• Maintain all credentials files ensuring that all correspondence in the credentialing and reappointment process is accurately filed; is knowledgeable and current on the process and legal/regulatory requirements
• Associate degree or an equivalent combination of education and experience required. Bachelor Degree preferred.
• Minimum one-year experience preferred in healthcare credentialing (i.e., healthcare facility, managed care setting, credentials verification organization, or Medical Staff Office)
• Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance preferred
• Demonstrated working knowledge of the health care and credentialing industry, including medical-legal issues and laws, regulatory agencies, and other national standards preferred
• Completion of post Cactus training testing of 85% or greater
• Understanding of professional telephone etiquette
• Able to work with minimal supervision and works well in both individual and group environment
CERTIFICATE/LICENSE - NAMSS certified at CPCS level preferred, or a commitment to pursue certification within one year
Parallon is an industry leader in revenue cycle services. We partner with over 650 hospitals and 2,400 physician practices nation-wide. Our parent company, HCA Healthcare has been consistently named a World's Most Ethical Company by Ethisphere and is ranked in the Fortune 100.
We are a family 270,000 strong! Our Talent Acquisition team is reviewing applications immediately. Highly qualified candidates will be promptly contacted by our hiring managers for interviews. Submit your resume today to join our community of caring!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Our Company's recruiters are here to help unlock the next possibility within your career and we take your candidate experience very seriously. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Gmail or Yahoo Mail. If you feel suspicious of a job posting or job-related email, let us know by clicking here.
For questions about your job application or this site please contact HCAhrAnswers at 1-844-422-5627 option 1.
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