Credentialing Specialist
Job Field: Legal Jobs
Location: BURIEN, WA
Salary: $-
Job Type: Part Time
JOB SUMMARY:
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<td align="left"><font style="font-size: 100%;">Title: Credentialing Specialist<BR>Location: WA - Seattle-Tukwila-Administrative South Building<BR>Other Locations: null<BR><BR>Collect and verify sensitive provider and practitioner data through confidential sources. Maintain timely updates to information systems and regular reports used to monitor completion of applications. Audit files based on internal standards and regulatory requirements. Assist other internal departments with application completion and system coordination activity. Work independently with very little supervision to meet specified timeframes. GH?s culture of compliance requires all staff to integrate applicable laws, regulations, and contractual obligations as a part of their daily standard work to ensure that process results meet these obligations.<BR>Education<BR>Minimum Education Requirements<BR>Associates Degree Associate Degree or equivalent education and work experience is required. Equivalent experience includes two years managed care, hospital or medical office environment.<BR><BR>Preferred Education<BR>Bachelors Degree Bachelors degree with coursework in healthcare<BR><BR><BR>Knowledge/Skills<BR>Minimum Knowledge/Skills Requirements<BR>Intermediate Basic computer skills, with Proven knowledge of database creation and maintenance and MS Work.<BR>Intermediate Communication Skills<BR>Intermediate Demonstrated ability to manage multiple priorities and competing deadlines.<BR><BR>Preferred Knowledge/Skills<BR>Basic or limited Knowledge of medical terminology desirable<BR><BR><BR>Experience<BR>Minimum Experience Requirements<BR>2 years 2 year experience working in a managed care, hospital or medical office environment required.<BR><BR>Preferred Experience<BR>3 years 3 years credentialing experience, working knowledge of NCQA and JCAHO or DNV credentialing and privileging standards preferred. Experience with credentialing software is desirable, Vistar software preferred<BR><BR><BR>License/Certifications<BR>Minimum License/Certifications Requirements<BR>Able to obtain shortly after hire Certified Provider Credentialing Specialist (CPCS) is required or within 12 months of hire.<BR><BR>Preferred License/Certifications<BR>None Required <BR><BR><BR><BR><BR>Group Health is an Equal Opportunity Employer committed to a diverse and inclusive workforce. </font></td>
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