Remote Provider Credentialing Specialist (Must live near Detroit, MI) - A-Line Staffing Solutions

Job Title: Remote Provider Credentialing Specialist

Pay: $18-$21 an hr | Bi-weekly

Job Type:Remote in Detroit, MI

Shift Options:

• M-F 8 Hour Days (Start Time between 7a - 9a) - 40 Hour Guarantee

Remote Provider Credentialing SpecialistOverview:

• Responsible for verifications for medical staff and allied health professionals' initial
  appointments, provisional reviews, reappointments, and privilege delineation;

• Coordinates the processing of applications.

• Assure all applications are processed completely and in a timely manner;

• Verifies required primary source credentialing documentation to ensure medical staff and allied health professional files are current and policies and procedures have been followed to obtain required documentation and verification;

• Coordinates activities and explains procedure to facilitate the reappointment process;

• Request confidential information such as case logs, procedures and other
  sensitive matters;

• Tracks responses and follows-up on items not received within established time
  frames;

• Maintains credentialing software database by ensuring that data entered is complete
  and accurate;

• Submit completed files to MSO offices and delegated entities;

• Acts as a liaison between Henry Ford Health System facilities and the CCS.

• Communicates with internal and external customers in a clear, concise manner to
  obtain or provide necessary information;

• Assist in compliance with the accrediting and regulatory agencies (i.e. The Joint
  Commission, NCQA, URAC, HFAP) in regards to credentialing while developing and
  maintaining a working knowledge of the statutes and laws;

• Improves professional growth, knowledge of job to maintain efficiency and
  effectiveness of the CCS by participating in professional organizations, attending
  seminars and reading journals and publications addressing medical staff services
  activities and trends;

• Participates in system integration and continuing quality improvement efforts;

• Receives, evaluates and answers customer inquiries and provides customer support
  in accordance with corporate standards of excellence;

• Performs other duties as required which are subject to change at the discretion of
  management.

Remote Provider Credentialing Specialist Qualifications:

• 2 Years of Prime Source Credentialing Experience - Required MUST have 1 Years of Hospital Credentialing Experience outpatient/clinic experience does not apply-
• Required MUST be proficient with using MDStaff Credentialing Software -
• End-to-end provider Credentialing Experience MDs amp DOs -
• Working knowledge of State and Federal law relating to due process and provisions of the Health Insurance Portability and Accountability Act of 1996 and all applicable standards.
• Must be able to work independently in a fast-paced environment
• Can be onsite or remote must live near Detroit - will be required to pick up equipment and briefly orient onsite
• Must be able to work full-time hours All RTO Requests scheduling conflicts etc.
• Must have access to a router in close proximity to a plug to set up the computer and ethernet
• Candidate must have excellent organization skills and be able to hit the ground running with minimal training.
• The expectation is to have 2-6 files completed daily.
• The candidate will start the assignment with 40 files to manage.

Remote Provider Credentialing Specialist Benefits:

• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance.
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates.

How to Apply:

If you are interested in this position, please apply OR submit your resume to:

Saw Hlaing | shlaing@alinestaffing.com | 412-790-5425