Our Mid-Missouri health clinics are growing again! Central Ozarks Medical Center is excited to announce we are looking to hire a Credentialing Specialist! Keep reading this week's blog to learn all about this position and how to apply for it. If you end up having any questions, please give us a call. All our phone numbers can be found on our website at www.CentralOzarks.org.
Credentialing Specialist
Richland, MO • Finance/Billing
Description
We are expanding our team to serve the needs of our community! Central Ozarks Medical Center (COMC) is excited to announce an opening for a Credentialing Specialist. COMC is a non-profit, federally qualified health center that has served Pulaski, Laclede, Camden and Miller counties for over 40 years with clinics located in Richland, Camdenton, and Osage Beach Missouri. COMC is looking for a team member who is comfortable working with patients from a diverse background. Must be a motivated, self-starter able to quickly adapt to new and changing conditions while maintaining a professional demeanor.
Responsibilities: The Credentialing specialist maintains regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations. They create and carry out various credentialing processes in relation to physicians, medical assistants, and various other healthcare professionals. They ensure that all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
· Responsible for the credentialing process for all COMC providers
· Process applications and reappointment paperwork for providers
· Review all forms and applications for accuracy and completeness prior to submission
· Process internal and external requests for privileges
· Ensure appropriate follow-up within established timeframes, monitor the credentialing process for each provider.
· Maintain timely and accurate data; update provider files with education, CEU training, renewed licensure, certifications, Insurance contracts, etc.
· Track expirations of provider certifications and licenses
· Conduct sanctions and compliance monitoring and alert leadership of any undisclosed negative findings immediately
· Prepare organizational records for audits; maintain communication with providers to ensure records are up to date
· Regularly verify licensures for providers; ensure the organization is compliant with current licensing and certification requirements and current healthcare laws and regulations
· Ensure strict confidentiality at all times.
· Performs other administrative duties as required.
Requirements
Qualifications Requirements: Strong organizational and critical thinking skills a must. High utilization and expertise in all Microsoft Office programs. Experience setting priorities and meeting deadlines while balancing the needs of competing obligations. Demonstrated effectiveness meeting deadlines and high attention to detail. Must be able to work independently, analyze data, and conduct research with performing the duties of the job. Excellent oral and written communication skills in an environment requiring confidentiality, diplomacy and judgment in managing interactions with individuals at all levels inside and outside of COMC. Experience with physician credentialing preferred.
Education and/or experience: High school diploma or equivalent. Preferred: Associates or Bachelor’s degree in Business, Healthcare, or related field.
Language Skills: Strong written and oral communication skills. Ability to effectively present information to internal and external stakeholders.
Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions.
Other Skills and Abilities: Outgoing personality with strong phone etiquette skills, outstanding customer service skills.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This includes moderate physical effort consisting of occasionally lifting or moving over 35 pounds of weight.
Travel Requirement: To fulfill the responsibility of the position travel to all COMC locations may be required. Employee must have valid Missouri driver’s license and availability of a motor vehicle.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Knowledge of, and adherence to, HIPAA and 340B regulations is required. Confidentiality of patient information and intellectual property is mandatory.
Ready To Apply and Possibly Become Part of the COMC Family?
Serving Camdenton, Laclede, Pulaski, and Miller Counties
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