Job Description
**POSITION SUMMARY:**
Responsible for submitting all credentialing and re-credentialing applications and attachments for all services and facilities within PruittHealth.
**WORKING RELATIONSHIPS:**
Directly Reports to: Director of Managed Care Contracts
**ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES:**
- Review and process incoming and outgoing paperwork, including directory updates, provider credentialing applications, demographic changes of services and other related forms.
- Provide office, project management and data analysis support.
- Maintain a comprehensive database of all facilities and payers with updated information regarding credentialing and re-credentialing
- Maintain a file with updated copies of all documents required for credentialing of all PruittHealth services.
- Answers incoming telephone inquiries from PruittHealth entities and payers regarding contracts and credentialing issues.
- Work closely with all PruittHealth entities and educate on the requirements of credentialing and re-credentialing.
- Support the Payer Relations with reports and updates regarding participation status with all payers.
- Maintain corporate standard time frame for completion of credentialing applications.
- Perform special projects upon request
- Excellent Communication, Customer Service and Time Management Skills
- Handles any additional duties as assigned by Management
**ESSENTIAL SKILLS AND COMPETENCY:**
- Ability to multi-task and handle consistent workflow
- Ability to think critically and work independently
- Attendance - must maintain timely, regular attendance.
- Communicates well with clients, vendors, fellow partners, visitors and family members providing warm and friendly greeting and an approachable attitude. Answers questions when appropriate in a professional manner.
- Develop and foster relationships
- Effective oral, written and telephone skills
- Excellent customer service and communication skills
- Initiative to follow-up on pending issues and organize and assign work
- Must be able to maintain confidentiality regarding company proprietary information
- Must have the ability to relate professionally and positively and work cooperatively with external partners and other employees at all levels
- Professional appearance. Dresses according to Company's Dress Code Policy
- Proficiency in MS Office Suite (Excel, PowerPoint, Word, Outlook, Teams, etc.)
- Work within scope of job requirements
**ESSENTIAL ADMINISTRATIVE FUNCTIONS:**
- Attends and participates in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification as required.
- Attends and participates in mandatory in-services.
- Complies with corporate compliance program.
- Performs other related duties as necessary and as directed by supervisor.
**PREFERRED SKILLS AND EXPERIENCE:**
- Minimum 2 years' experience in healthcare contract credentialing or equivalent
**Family Makes Us Stronger.** Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.
We are eager to connect with you! **_Apply Now_** to get started at PruittHealth!
_As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status._
Job Tags
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