• Job Description

  Req#: 2071445

  • This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

  • Our ideal candidate will have experience in facility enrollment and revalidation processes with federal and state agencies including CMS and Medicaid programs. Familiarity with facility specific processes and applications in PECOS, NPPES and Oregon Medicaid portals is a plus.
  • JOB SUMMARY/PURPOSE
    • Independently manages all activities associated within the initial and re-credentialing application process and/or the provider enrollment process, which may include primary source verification of licensure, certification and credentials for the purpose of employment; hospital privileges and health plan membership; facility credentialing; provider/facility enrollment with payers; and delegation agreement management. Acts as a subject matter expert for Primary Source Verification, Provider Enrollment and Facility Credentialing. Collaborates with Medical Staff and Samaritan Health Plan offices to ensure accuracy and completeness of files and reduce duplication of credentialing activities. Serves as a system expert for management of system wide provider database. Acts as a liaison and mentor for Credentialing Coordinator I employees.
  • DEPARTMENT DESCRIPTION
    • The Credentialing Department at Samaritan Health Services credentials new and existing healthcare providers for employment, privileging and participation in Samaritan Health Plans. The credentialing process includes verification, documentation, and approval of a practitioner's credentials and meets the requirements of The Centers for Medicare and Medicaid and our accrediting bodies.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • High School diploma or equivalent required. Completion of college coursework preferred.
    • Four (4) years experience in a position of similar responsibility and complexity, including one (1) year experience in credentialing and MSOW applications required.
    • Experience and/or training in theories, concepts, and principles of secretarial science and office management required.
    • Experience and/or training in regulatory compliance including The Joint Commission, DNV, NCQA and CMS as it applies to credentialing standards, required.
    • Experience and/or training in medical staff structure required.
    • Experience and/or training in computer applications including Microsoft Word, Outlook and Excel required.
    • CPCS certification preferred.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Computer Literacy - Knowledge of computer software, including Microsoft Office programs and web based applications. Ability to operate applications, enter data, and manipulate and process information.
    • Clerical - Knowledge of theories, concepts, and principles of secretarial science and office management. Ability to perform administrative and clerical procedures.
    • Credentialing - Knowledge of accreditation, NCQA, medical staff standards and state/federal requirements as they relate to credentialing services.
    • Communication – Possess professional verbal and written communication skills for interacting with customers of Credentialing Department.
  • PHYSICAL DEMANDS

    • Rarely (1 - 10% of the time)	Occasionally (11 - 33% of the time)	Frequently (34 - 66% of the time)	Continually (67 – 100% of the time)
      CLIMB - STAIRS LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs LIFT (Knee to chest: 24"-54") 0 – 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds SQUAT Static (hold >30 sec) SQUAT Repetitive BEND FORWARD at waist KNEEL (on knees)	STAND WALK – LEVEL SURFACE REACH - Upward ROTATE TRUNK Standing PUSH (0-20 pounds force) PULL (0-20 pounds force)	SIT ROTATE TRUNK Sitting REACH - Forward CARRY 2-handed, 0 - 20 pounds	MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist

• About the company

  The Samaritan Health Services is a non-profit, integrated delivery healthcare system consisting of five hospitals in Oregon and is headquartered in Corvallis, Oregon.

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