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Credentialing Verifier

Company: Parallon
Location: Nashville
Posted on: July 24, 2019

Job Description:

Description SHIFT: No Weekends

SCHEDULE: Full-time

(This is a 32 hour position)
JOB TITLE: CredentialingVerifier --GENERAL SUMMARY OF DUTIES --- Responsible for credentialing collection andverification activities as it relates to initial credentialing,re-credentialing, and credentials modification. Tracking of issues associatedwith activities necessary to maintain and document ongoing compliance with CPCpolicy and procedures. As requested, will be expected to assist with othertasks/ projects. Compliance with HCA policy and procedures, Federal and Stateregulatory and accrediting agencies is required. SUPERVISOR --- CPC Manager SUPERVISES - None DUTIES INCLUDE BUT ARE NOTLIMITED TO: ---Receive requests for Provider Action Forms (PAFs), Requests for Consideration(RFCs), and Reappointment Requests for Consideration (RRFCs and determinewhether provider is already in Cactus system ---Compile RFC and RRFC packets in Cactus ---Responsible tracking of all RFC and RRFC packets and correspondence andmaintaining documentation as requested ---Manual data entry of information into Cactus system for credentialing andrecredentialing processes and data/image maintenance processes ---Accurately perform a variety of administrative duties such as: data/imagereview, verifying data, placing calls, processing incoming data/images,processing facsimile verifications, scanning, sending written inquires, filing,copying, and other duties as needed. ---Review RFC and RRFC packets for completeness of information, identify missinginformation ---Pursue incomplete information and documents ---Assure correct verifications obtained based on specific provider---s data and CPCpolicy and procedures, including but not limited to: state license(s), Federaland State DEA(s), board certification, education, and peer references. ---Prepare, scan, attach, send correspondence, and receive correspondence ofcredentialing and recredentialing data and images within RFC and RRFC documentsfor process review ---Assure timeliness of process completion ---Assure confidentiality of data ---Ensure that all provider data/images are current and complete pursuant toexpiration date per CPC policy and procedures. ---Advise Credentialing Specialist of questionable information received and anyissues identified during the processes. ---Compliance with HCA policy and procedure, Federal and State regulatory andaccrediting agencies as required. ---Practice and adhere to the ---Code of Conduct--- philosophy and ---Mission and ValueStatement--- --- Perform other duties andworks on special projects as requested. --KNOWLEDGE, SKILLS &ABILITIES ---Organization --- proactively prioritizes needs and effectively manages resources.Ability to show attention to detail. ---Communication --- communicates clearly and concisely. Must have excellentinterpersonal and written communication skills. This includes spelling andgrammar skills and basic mathematical calculations. --- Customer orientation ---establishes and maintains long-term customer relationships, building trust andrespect by consistently meeting and exceeding expectations. --- Policies & Procedures --- articulates knowledge andunderstanding of organizational policies, procedures, and systems. --- PC Skills --- demonstrates proficiency in Microsoft Office(Excel, Access, Word), Cactus, and HCO applications and other as required. --- Ability to maintain confidentiality of privilegedinformation gained. --- Ability to work independently, in teams, and underpressure. ---Credentialing & Privileging technical skills ---credentialing process andprimary source verification knowledge. --EDUCATION --- High SchoolGraduate or GED. Associate degree or an equivalent combination of education andexperience preferred. --EXPERIENCE --- At least 1 year previous office experience including dataentry, typing, and basic computer usage and proficient keyboard and PC skillspreferred --- Previous Credentialing experience preferred. Basicknowledge of credentialing processes and standards preferred --- Typing speed as follows: Intake, Dynamics, Correspondence,On-line: 25 wpm; Data Integrity Keyer: 40 wpm. --- Completion of post Cactus training testing of 80% orgreater --- Understanding of professional telephone etiquette --- Able to workwith minimal supervision and works well in both individual and groupenvironment --PHYSICALDEMANDS/WORKING CONDITIONS -Requires prolonged sitting, some bending, stooping and stretching. Requireseye-hand coordination and manual dexterity sufficient to operate a keyboard,photocopier, telephone, calculator and other office equipment. Requires normalrange of hearing and eyesight to record, prepare and communicate appropriatereports. Requires lifting papers or boxes up to 50 pounds occasionally. Work isperformed in an office environment. Work may be stressful at times. Contact mayinvolve dealing with angry or upset people.

Company Description:

HCA Healthcare is a collaborative healthcare network, driven by physicians, nurses and colleagues helping each other champion the practice of medicine to give people a healthier tomorrow. With a comprehensive network of more than 270,000 people across approximately 1,800 care facilities, our scale enables us to deliver great outcomes for our patients, provide superior nursing care and be a preferred place for physicians to practice medicine. We never stop in our pursuit of insights and care advances based on the knowledge and data we gain from approximately 30 million patient encounters a year. Every day, we raise the bar to improve the way healthcare is delivered, not just in our facilities, but everywhere. We---re committed to improving more lives in more ways, and above all else, we are committed to the care and improvement of human life.

Keywords: Parallon, Clarksville , Credentialing Verifier, Other , Nashville, Tennessee

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