Work from Home Credentialing Support Assistant – Full Time (Remote Jobs Hiring)
Job Responsibilities : Work from Home Credentialing Support Assistant – Full Time (Remote Jobs Hiring)
Salary : Competitive Salary
Company : Prospect Medical Systems – CA
We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.
The Credentialing Support Assistant this position performs administrative/clerical duties for the Credentialing Department.
Job Responsibilities/Duties
Responsible for the generating, mailing, tracking, and subsequent processing of HDO re-credentialing applications. All re-credentialing files are to be completed within a 36 month timeframe. Update new information as received via re-credentialing process.
Process Initial and Re-Credentialing Applications as they come in (includes: reviewing, data entry, assigning to Credentialing Coordinators and following up for missing documents)
Track Re-Cred Applications received using an excel spread sheets and Morrisey notes
Coordinate with the Contracting Department to confirm and track terminated and pending terminated providers
Track the status of Initial Credentialing Applications using an excel spread sheet
Answer ad-hoc questions regarding the credentialing status of providers (phone calls and emails)
Submit initial provider profiles to appropriate Contracting department within one (1) day after Committee approval.
Handle in-coming Department phone calls.
Distribute in-coming mail.
Send credentialing files to the CVO and track progress using excel spread sheets and Morrisey notes
Ensure all due recreds are returned on a timely manner and ensure Performance Standards are being met
Follow-up on providers responsiveness/issues found by the CVO
Assign the CVO returned files to the coordinators immediately after return and ensure timely completion by using the report
Notifies management of any expirables that are in jeopardy of becoming delinquent. Ensures accuracy of the expirables database and sends out reminders to members per policy.
Follows up in obtaining missing information.
Maintain daily logs to reflect correct reporting.
Responsible for the generating, mailing, tracking, and subsequent processing of provider initial and re-credentialing applications.
All re-credentialing files are to be completed within 36 month timeframe.
Qualifications
Minimum Education: High school diploma or equivalent.
Minimum Experience: Previous credentialing experience with at least one year IPA/Medical Group experience preferred.
Req. Certification/Licensure: None.
Employee Value Proposition
Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts.
As a member of our highly effective team of professionals, benefit eligible positions will receive:
Company 401K
Medical, dental, vision insurance
Paid time-off
Life insurance
How to Apply
To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.
