Credentialing Administrator

Concentra, Inc; Addison (TX); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

401(k) Employer Match

Medical, Vision, Prescription, Telehè

Dental Plans

Life & Disability Insurance

Paid Time Off

Tuition Reimbursement

Commuter Benefits

Dependant Care Spending Account

Employee Discounts

Job summary

Concentra, Inc. in Addison, TX is seeking a Credentialing Administrator to support the Contracting and Credentialing teams.

You will launch IntelliCred workflows, track DOT and APC/ATC certifications, and manage facility credentialing with payers and providers. Responsibilities include maintaining licensure, audits, and payer contracts, plus handling internal credentialing verification charges and reporting.

Qualifications

• Diploma or GED required with related field degree or experience.
• Minimum 2 years of administrative experience.
• Proficient in Excel and Microsoft Office applications.
• Knowledge of HIPAA and PHI confidentiality.

Responsibilities

• Support DOT certification tracking for physicians, NPs, and PAs.
• Track APC/ATC agreements for new hires and renewals.
• Manage facility credentialing for payers and provider rosters.
• Coordinate licensure activities with licensing department.
• Conduct internal audits and data integrity checks in IntelliCred.
• Launch workflows for Medicare, Group Health, and QA in IntelliCred.
• Assist in acquisition-related credentialing activities and reporting.
• Maintain department admin tasks and shared facility listings.
• Track contracts and maintain payer contract files.

Skills

Administrative experience

Excel skills

Microsoft Office

HIPAA knowledge

Education

High School Diploma or GED

Related field degree or equivalent

Tools

IntelliCred

Concur

NRCME Website

Job description

Credentialing Administrator

Location: US-TX-Addison

Job ID: 352420

Pos. Category: Corporate - Other

Pos. Type: Full Time

Recruiter: Enrique Camblor

Overview

Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process.

Primary responsibilities include, but are not limited to, day-to-day support for the Contracting and Credentialing teams including launching of team workflows in the IntelliCred database; manage and track DOT and APC/ATC certification and compliancy; facility credentialing for Group Health payers; tracking of group health payer agreements/contracts for executive review/signatures; allocating and submitting expenses for internal credentialing verification charges.

Responsibilities

• Serve as support for maintaining and tracking DOT certifications for all physicians, nurse practitioners, and physician assistants. Research/validate DOT certification and practice profiles via the National Registry of Certified Medical Examiners (NRCME) website. Notification of DOT certification and practice profile status is communicated to the field EAs and tracked for Concentra compliancy through the IntelliCred database
• Serve as support for maintaining and tracking all APC/ATC agreements for compliancy. Submits written request to field EAs for APC/ATC agreements for all new hire, annual/biennial renewals and supervising physician changes of Nurse Practitioners, Physician Assistants, and Athletic Trainers. Completion of APC agreement requests are tracked and monitored for compliancy through the IntelliCred database
• Facilitate, maintain and track facility credentialing applications for Urgent Care, Physical Therapy, Primary Care and Work Comp payers. Includes completion of simple to complex credentialing applications with supporting documents such as local, state, and federal licensures, CLIA certificates, center assessment and services offered questionnaires. Credentialing activities are maintained and tracked in the IntelliCred database through various workflows
• Act as the primary liaison to secure needed facility licensures by working with internal licensing department, clinical and operational leaders.
• Conduct internal audits such as facility rosters and various IntelliCred database validations to ensure data integrity
• Launching workflows in the IntelliCred system for Medicare, Group Health and Quality Control and Administration teams for new hires, terms, location updates for clinician Medicare enrollment, external payer credentialing needs, APC Collaborative Agreements and DOT certification compliancy
• Participate in acquisition activities for the department to include but not limited to launching workflows for all teams, updating all internal facility rosters and IntelliCred Group records
• Maintain all departmental administrative tasks such as office supplies, incoming/outgoing mail, Fed Ex, department contact lists, etc.
• Create and maintain internal Facility Listings on shared drive and Groups/Locations in database to include facility demographics, NPIs, legal entity, TIN, Medicare PTAN and billing information utilized by the department and for external Group Health payer needs. Prepare various reports such as custom facility listings and provider rosters as requested for internal and external clients
• Track contracts for review and signature by executive leaders. Maintain all Group Health payer contract files via electronic and hard-copy file system
• Reconciliation for Internal Credentialing verification charges. Obtain receipts for each transaction, validate and allocate the correct billing string for biweekly submission through the Concur expense reporting system

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications

Education Level: High School Diploma or GED

Major:

Degree must be from an accredited college or university.

Education Details:

• A college degree in related field or equivalent work experience.

Job-Related Experience

Customarily has at least the following experience: 2 years

• Customarily has at least 2 years of administrative skills experience
• Moderate to advanced Excel skills

Job-Related Skills/Competencies

• Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
• Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
• The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
• Ability to accurately type
• Detail oriented and highly organized
• Microsoft Office Suite
• Excellent verbal and written communication skills
• Ability to utilize all proprietary Concentra software programs
• Ability to work independently within company guidelines and policies
• Ability to effectively present information and respond to questions from managers, clients, and customers
• Ability to speak effectively in one-on-one situations
• Ability to read and comprehend standardized instructions, short correspondence, and memos
• Ability to effectively present information in one-on-one situations to other employees, providers, and clients
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
• Ability to apply commonsense understanding to carry-out instructions furnished in written, oral, or diagram form
• Basic understanding of office equipment (copier, scanner, fax, phone)

Additional Data

Employee Benefits

• 401(k) Retirement Plan with Employer Match
• Medical, Vision, Prescription, Telehealth, & Dental Plans
• Life & Disability Insurance
• Paid Time Off
• Colleague Referral Bonus Program
• Tuition Reimbursement
• Commuter Benefits
• Dependent Care Spending Account
• Employee Discounts

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation, if required.

*This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management*

Concentra is an equal opportunity employer that prohibits discrimination, and will make decisions regarding employment opportunities, including hiring, promotion and advancement, without regard to the following characteristics: race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.