Provider Application Processing Specialist

Integrated Resources Inc.; Harrisburg (Dauphin County); On-site; USD 40,000 - 60,000; Full time

Job summary

A leading company in workforce solutions seeks a Provider Application Processing Specialist to coordinate credentialing functions. The role involves communicating with healthcare providers and managing credentialing packets to ensure compliance. Ideal candidates will have a high school diploma and preferably some experience in credentialing within managed care settings.

Qualifications

• High school diploma is required.
• Experience in Managed Care or Health Care environment is highly desired.

Responsibilities

• Submit credentialing packet information to providers.
• Assemble credentialing materials for submission.
• Communicate with Provider Contracting staff.

Skills

Credentialing Experience

Communication

Administrative Skills

Education

High school graduate or equivalent

Job description

Provider Application Processing Specialist

Contract

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.

Under the supervision of the Manager of Network Operations, the Provider Application Processing Specialist is responsible for coordinating the credentialing functions for the client.

The Application Processing Specialist coordinates all written communication to physicians, hospitals and ancillary providers to assure all credentialing information is complete for presentation to the Corporate Credentialing Department.

Performs a variety of secretarial, administrative, and clerical duties for Provider Network Operations.

Responsibilities

• Responsible for submitting credentialing packet information to physicians, hospitals and ancillary providers when participation in the provider network is requested.
• Submits provider information to delegated credentialing organizations for credentialing data elements.
• Assembles provider credentialing materials received for submission to corporate credentialing department.
• Follows up with Provider Contracting representatives on outstanding items necessary for credentialing.
• Forwards provider information to all required corporate departments.
• Communicates openly with Provider Contracting staff and the Credentialing department.
• Performs other related duties and projects as assigned.
• Adheres to client’s policies and procedures.
• Supports and carries out the client’s Mission & Values.
• Attends required training on an annual basis.

Minimum Requirements:

• High school graduate or equivalent – Required
• Previous Credentialing Experience – Highly Desired
• Experience in Managed Care or the Health Care environment – Highly Desired