Remote Credentialing Verifier II: Compliance & Data Expert

Parallon; Houston (TX); Remote; USD 52,000 - 68,000; Full time

Benefits offered by this job

Work from home

Comprehensive benefits

401(k) with match

Education support

Job summary

Parallon is seeking a Credentialing Verifier II to support initial credentialing and re-credentialing activities. This remote role involves researching and resolving complex situations, maintaining CPC policy compliance, and assisting with special projects.

The position requires attention to detail, proficiency with credentialing systems, and the ability to work with minimal supervision. Candidates must live within 60 miles of an HCA facility or be within the remote work program.

Qualifications

• High School Graduate or GED. Associate degree or an equivalent combination of education and experience preferred.
• Minimum 1 year experience within Parallon credentialing Processing Center required.
• Completion of credentialing knowledge assessment and post Cactus training testing of 90% or greater.
• Professional telephone etiquette.
• Able to work with minimal supervision and works well in both individual and group environment.
• Successful completion of Credentialing 100, 101 and portions of 201 as it relates to verifier duties at the Parallon Credentialing Processing Center.

Responsibilities

• Process Provider Action Forms (PAFs), Request for Consideration (RCFs) and Reappointment Requests for Consideration (RRFCs) and determine whether provider is already in Cactus system.
• Create/compile RFC/RRFC packets in Cactus.
• Track all RCF and RRFC packets and correspondence and maintaining documentation as requested.
• Manual data entry of information into Cactus system for credentialing and re-credentialing processes and data/image maintenance processes.
• Accurately perform a variety of administrative duties such as data/image review, verifying data, placing calls, processing incoming data/images, processing facsimile verifications, scanning, sending written inquiries, filing, copying and other duties as needed.
• Review RFC and RRFC packets for completeness of information and identify missing information.
• Identify Incomplete and Unable to Key CVI’s and pursue incomplete information and documents.
• Create new CVI’s as applicable and notification and confirmation with MSO to confirm processing timeframe.

Skills

Credentialing knowledge

Data entry

Professional communication

Telephone etiquette

Education

High School Diploma or GED

Associate degree preferred

Tools

Cactus system

Document Management Outbound

Background Checks systems

Job description

Parallon is seeking a Credentialing Verifier II to support initial credentialing and re-credentialing activities. This remote role involves researching and resolving complex situations, maintaining CPC policy compliance, and assisting with special projects.

The position requires attention to detail, proficiency with credentialing systems, and the ability to work with minimal supervision. Candidates must live within 60 miles of an HCA facility or be within the remote work program.