Credentialing Assistant

Credentialing AssistantThis position provides high quality support for credentialing functions within the health plan. Core responsibilities include records management, document management, and customer service as defined in CareOregon credentialing policies and procedures. This position works closely with the Credentialing Specialist and Credentialing Supervisor in the credentialing process to ensure all applications, primary source documentation, and notifications meet regulatory guidelines.Estimated Hiring Range:
$20.89 - $25.54Bonus Target:
Bonus - SIP Target, 5% AnnualCurrent CareOregon Employees: Please use the internal Workday site to submit an application for this job.
Essential Responsibilities

Maintain records according to protocol.

Keep records in a retrievable manner to support regulatory requirements.

Retrieve records as needed for activities such as document reviews and audits.

Coordinate and communicate with records management.

Maintain confidential and time sensitive material.

Review provider credentialing applications upon receipt and verify requirements are met to start the credentialing process.

Enter provider information in databases, maintaining accuracy and completeness of provider information.

Communicate routinely with other departments to ensure records are being processed according to workflows.

Communicate with providers regarding applications by telephone and in writing.

Maintain records of applications and credentialing approval letters.

Maintain a detailed and confidential credentialing system.

Conduct quality audits of credentialing files.

Run required reports to support Credentialing team.

Assist in the verification of healthcare professional’s information with external verification sources, such as Oregon Board of Medical Examiners and other sources as needed.

Assist Credential Specialists in meeting team goals and deadlines.

Assist in audit prep for external and internal entities.

Perform annual and ongoing document reviews.

Create job aids as needed.

Experience and/or Education
Required
Minimum 1 year experience in any of the following: Health plan credentialing, medical office, high-production word processing, and/ or work requiring regular use of Access or other databases

Preferred
Experience with SharePoint and knowledge of medical terminology

Knowledge, Skills and Abilities Required
Knowledge

Basic knowledge of quality assurance and/or compliance

Knowledge of or ability to learn the provider credentialing process

Knowledge of or ability to learn document management systems

Skills and Abilities

Ability to retain and maintain confidential files

Strong organizational skills

Competency with word processing

Competency with spreadsheet and database management

Demonstrated personal initiative and good judgement

Ability to write and communicate verbally effectively

Ability to work autonomously

Ability to perform strong attention to detail to ensure accuracy

Ability to manage multiple tasks

Ability to work in a confidential manner with Provider information

Ability to work as a member of a team in a collaborative manner

Ability to work effectively with diverse individuals and groups

Ability to learn, focus, understand, and evaluate information and determine appropriate actions

Ability to accept direction and feedback, as well as tolerate and manage stress

Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day

Ability to hear and speak clearly for at least 3-6 hours/day

Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment
Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.
Work Location: Work from home
We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.
We are an equal opportunity employer
CareOregon is an equal opportunity employer.  The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.
Originally posted on Himalayas