Credentialing Coordinator I

Samaritan Health Services; Corvallis (OR); On-site; USD 29,000 - 43,000; Full time

Job summary

Samaritan Health Services in Corvallis, OR is seeking a Credentialing Specialist responsible for managing initial and re-credentialing applications, verifying licensure, and enrolling providers with payers. You will collaborate with Medical Staff and Samaritan Health Plan, ensure accuracy, and maintain the system-wide provider database, supporting employment, privileging and plan participation.

Requirements include a high school diploma, two years of relevant experience, and knowledge of

Qualifications

• High school diploma or equivalent required.
• Two (2) years experience in a position of similar responsibility and complexity required.
• Experience and/or training in theories, concepts, and principles of secretarial science and office management required.
• Experience and/or training in regulatory compliance including The Joint Commission, DNV, NCQA and CMS required.
• Experience and/or training in medical staff structure preferred.
• Experience and/or training in computer applications including Microsoft Word, Outlook and Excel required.

Responsibilities

• Independently manages all activities within the initial and re-credentialing application process and/or provider enrollment process.
• Performs primary source verification of licensure, certification and credentials for employment, hospital privileges and health plan membership.
• Collaboration with Medical Staff and Samaritan Health Plan offices to ensure accuracy and completeness of files and reduce duplication of credentialing activities.
• Serves as a system resource for management of system wide provider database.

Skills

Microsoft Word

Microsoft Outlook

Microsoft Excel

Communication

Tools

Microsoft Word

Microsoft Outlook

Microsoft Excel

Job description

Salary Range Salary Range: $21.34 - $31.33

This is a remote position in which we are able to employ in the following states:Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

JOB SUMMARY/PURPOSE

Independently manages all activities associated within the initial and re-credentialing application process and/or the provider enrollment process, which may include primary source verification of licensure, certification and credentials for the purpose of employment, hospital privileges and health plan membership; facility credentialing; provider/facility enrollment with payers; and delegation agreement management. Collaborates with Medical Staff and Samaritan Health Plan offices to ensure accuracy and completeness of files and reduce duplication of credentialing activities. Serves as a system resource for management of system wide provider database.

DEPARTMENT DESCRIPTION

The Credentialing Department at Samaritan Health Services credentials new and existing healthcare providers for employment, privileging and participation in Samaritan Health Plans. The credentialing process includes verification, documentation, and approval of a practitioner's credentials and meets the requirements of The Centers for Medicare and Medicaid and our accrediting bodies.

EXPERIENCE/EDUCATION/QUALIFICATIONS

High School diploma or equivalent required.

Two (2) years experience in a position of similar responsibility and complexity required.

Experience and/or training in theories, concepts, and principles of secretarial science and office management required.

Experience and/or training in regulatory compliance including The Joint Commission, DNV, NCQA and CMS required.

Experience and/or training in medical staff structure preferred.

Experience and/or training in computer applications including Microsoft Word, Outlook and Excel required.

CPCS certification preferred.

KNOWLEDGE/SKILLS/ABILITIES

Computer Literacy - Knowledge of computer software, including Microsoft Office programs and web based applications. Ability to operate applications, enter data, and manipulate and process information.

Clerical - Knowledge of theories, concepts, and principles of secretarial science and office management. Ability to perform administrative and clerical procedures.

Credentialing - Knowledge of accreditation, NCQA, medical staff standards and state/federal requirements as they relate to credentialing services.

Communication – Possess professional verbal and written communication skills for interacting with customers of Credentialing Department.

PHYSICAL DEMANDS

Rarely
(1 - 10% of the time)

Occasionally
(11 - 33% of the time)

Frequently
(34 - 66% of the time)

Continually
(67 – 100% of the time)

CLIMB - STAIRS

LIFT (Floor to Waist: 0\"-36\") 0 - 20 Lbs

LIFT (Knee to chest: 24\"-54\") 0 – 20 Lbs

LIFT (Waist to Eye: up to 54\") 0 - 20 Lbs

Join our Talent Network to opt-in to all our current and future opportunities!

Learn more about culture in Corvallis, OR.