Credentialist I
Company: Helen Ross McNabb Center
Location: Knoxville
Posted on: March 1, 2025
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Job Description:
Credentialist IHelp Others, Make a Difference, Save a Life.Do
you want to make a difference in people's lives every day?Or help
people navigate the tough spots in their life?And do it all while
working where your hard work is appreciated?You have a lot of
choices in where you work---make the decision to work where you are
valued!Join the McNabb Center Team as the Credentialist I today!The
Credentialist IJOB PURPOSE/SUMMARYSummary of role of team: The
Human Resources team provides an array of services to support all
Center staff. The Credentialing team specifically works to ensure
that clinical providers meet all requirements to secure
reimbursement for services provided on behalf of the Center.Summary
of position: Credentialists 1 (Internal) work closely with our
providers and our insurance partners to guarantee staff are cleared
and rostered in a timely manner to allow for service reimbursement.
The Credentialist 1 is responsible for completing all internal
credentialing for licensed providers, including: CAQH maintenance
and ensuring all other participation documentation is accurately
completed and submitted on time. This staff will regularly
coordinate with internal teams to ensure compliance and
reimbursement as well as perform any needed follow up with
insurance partners to verify credentialing is complete and
accurate.TYPICAL WORKING CONDITIONS/ENVIRONMENTThis position
operates primarily out of administrative office with limited visits
to clinics or other offices.JOB DUTIES/RESPONSIBILITIESThis job
description is not intended to be all-inclusive; and employee will
also perform other reasonably related job responsibilities as
assigned by immediate supervisor and other management as required.
This organization reserves the right to revise or change job duties
as the need arises. Moreover, management reserves the right to
change job descriptions, job duties, or working schedules based on
their duty to accommodate individuals with disabilities. This job
description does not constitute a written or implied contract of
employment.1. Demonstrates professionalism through responsiveness,
a positive work climate, and cultural competency.Engages
supervisors in a positive, professional manner with a servant
attitude and continually follow up if there are any outstanding
items the staff needs to turn in.Has a servant attitude and
behaviors as evidenced by no complaints.Works well with other
departments as evidenced by co-worker and department supervisor
report.Embodies professionalism through daily teaming with
financial services.2. Coordinates the internal credentialing
requirements for the Center, following policy, procedures, and
guidelines for insurance companies we contract with.Follows P&P
to credential eligible employees within designated timeframes,
coordinating with appropriate team members as necessary.Provides
updated internal credentialing documentation to the External
Credentialist I to ensure that the quarterly, monthly, and as
needed rosters are updated and submitted to all of the contracted
insurance companies.Maintains provider websites and rosters,
ensuring all information is current and accurate for new staff,
current staff, and terminated staff.Website tasks typically to
include: PECOS (Medicare) and I&ADistributes internal
credentialing complete memo to provider and all relative staff when
all the internal processes are completed.Maintains CAQH accounts
for each credentialed employee on CAQH portal, including
attestation every 90 days and upload of annual liability
coverage.Responsible for continual audits to ensure current and
accurate information provided on profiles.Complete checklist for
all licensed staff terminating from the Center.Work closely with
billing and follow up management within Financial
Services.Communicate with Accounts Receivable (AR) on potential
billing issues due to credentialing for providers.Correspond
regularly with credentialing team and AR for updates on
credentialing status for providers.3. Other miscellaneous duties
include:Sits on credentialing committee, TAMHO monthly provider
calls, and attends various informational conferences related to
credentialing processes.Supports credentialing team members as
assigned.Work closely with members of the HR team on various other
duties as needed.Miscellaneous reporting duties on an as needed
basis.COMPENSATION: Starting salary for this position is
approximately $17.24-$17.90 /hr based on relevant experience and
education.Schedule: Must be able to have excellent attendance and
start the workday at assigned time. Typical administrative office
hours are Monday-Friday from 8am-5pm daily. Flexibility is
determined on a case-by-case basis with the supervisor & leave
requests require supervisor approval.Travel: This position is
office-based with some occasional travel to other Center offices
for training or duties.Equipment/Technical Competency: Must have
excellent computer skills (especially Excel) and the ability to
learn new software products quickly. Must be able to complete a
large amount of computer data entry and communication with
supervisors daily. Should be proficient on a variety of office
equipment, including: copier, scanner, fax machine, computer
desktop/laptop, telephone, etc.Equipment/Technology: Must be able
to use a computer, telephone, and office equipment to complete job
duties.QUALIFICATIONS - Credentialist IExperience / Knowledge:
Computer experience in a health care setting required. Human
resource, credentialing, or medical billing preferred. Knowledge of
human resource policies and employment law preferred. Clinical
experience and knowledge preferred.Education / License: Bachelor's
degree or high school diploma with at least 1 year of direct
provider credentialing experience
required.Physical/Emotional/Social - Skills/Abilities:Must be able
to do long periods of sitting and standing. Close computer work
required. Must be able to see with correction, hear normal tones,
and talk on phone / in person. Excellent interpersonal &
communication skills needed. Ability to role-model preferred. Must
be able to work effectively in a team with various
personalities.Location: Knox County, TennesseeApply today to work
where we care about you as an employee and where your hard work
makes a difference!Helen Ross McNabb Center is an Equal Opportunity
Employer. The Center provides equal employment opportunities to all
employees and applicants for employment and prohibits
discrimination and harassment of any type without regard to race,
color, religion, age, sex, national origin, disability status,
genetics, protected veteran status, sexual orientation, gender
identity or expression, or any other characteristic protected by
federal, state or local laws. This policy applies to all terms and
conditions of employment.Helen Ross McNabb Center conducts
background checks, driver's license record, degree verification,
and drug screens at hire. Employment is contingent upon clean drug
screen, background check, and driving record. Additionally, certain
programs are subject to TB Screening and/or testing. Bilingual
applicants are encouraged to
apply.PI5e0a52ccf05b-25660-36947947
Keywords: Helen Ross McNabb Center, Knoxville , Credentialist I, Other , Knoxville, Tennessee
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