Verifier position will be responsible for credentialing collection and verification activities as it relates to initial credentialing, re-credentialing, and dynamic credentialing. Tracking of issues associated with activities necessary to maintain and document ongoing compliance with CPC policy and procedures. As requested, will be expected to research and resolve complex situations and assist with other tasks/projects.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
• Receive requests for applications
• Compile application and send to practitioner
• Responsible for intake and tracking of all applications and correspondence and maintaining documentation as requested
• Assist in the credentialing process by data entry of information into credentialing system for initial, updated, add on applications and maintenance processes
• Accurately perform a variety of administrative duties such as: placing calls, processing incoming mail, processing facsimile verifications, scanning, sending written inquires, filing, copying, and other duties as needed
• Review for completeness of information, identify deficiencies
• Pursue incomplete information
• Process and maintain credentialing and recredentialing 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
• Compliance with HCA policy and procedure, Federal and State regulatory and accrediting agencies as required•
KNOWLEDGE, SKILLS & ABILITIES
• Organization - proactively prioritizes needs. Ability to show attention to detail.
• Communication - communicates clearly and concisely. Must have excellent interpersonal and written communication skills. This includes spelling and grammar skills and basic mathematical calculations.
• Customer - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures, and systems.
• PC Skills - demonstrates proficiency in Microsoft Office (Outlook, Excel, Access, Word) applications and others as required.
• Ability to maintain confidentiality of privileged information gained.
• Ability to work independently and under pressure.
• Credentialing & Privileging technical skills -credentialing process and primary source verification knowledge.
• High School Graduate or GED. Associate degree or an equivalent combination of education and experience preferred.
• At least 1 year previous office experience including data entry, typing, and basic computer usage and proficient keyboard and PC skills preferred.
• Previous Credentialing experience preferred. Must have basic knowledge of the Credentialing process and standards.
• Typing speed 50 words per minute.
• Completion of post Cactus training testing of 90% or greater.
• Understanding of professional telephone etiquette.
• Able to work with minimal supervision and works well in both individual and group environment.
A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom