• Job Description

  Req#: 18-01161
  Job Title: Credentialing Coordinator
  Location: Irving TX. 75038
  Duration: 3+ Months Contract
  
  POSITION SUMMARY:
  This individual will be responsible for coordinating all aspects of the credentialing and primary source verification process for practitioners and health delivery organizations according to Children's Medical Center Health Plan policy and procedures.
  
  JOB SPECIFIC RESPONSIBILITIES:
  • Process initial and re-credentialing applications from providers, per policy.
  • Complete data entry of applications, reviewing them for errors prior to turning in the provider files for quality review, meeting departmental requirements.
  • Conduct primary source verification per policy.
  • Prepare and send out re-credentialing applications, per policy.
  • Complete all requests for re-credentialing packets, per policy.
  • Assist with oversight of delegated entities as needed.
  • Send report to various state plans/departments to identify any providers who haven't returned their re-credentialing applications or who are past-due for credentialing, meeting departmental requirements.
  • Complete monthly audit of Federal and State exclusion lists and report any adverse findings.
  • Ensure that follow-up occurs for the ongoing state license action monitoring reports, per policy.
  • Assist with coordinating credentialing committee.
  
  Specific Knowledge, Skills and Abilities:
  • Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to work within new work structures, processes, requirements, or cultures.
  • Use appropriate interpersonal styles to establish effective relationships with customers and internal partners; interact with others in a way that promotes openness and trust and gives them confidence in one's intentions.
  • Ensure that the customer perspective is a driving force behind business decisions and activities; craft and implement service practices that meet customers' and own organization's needs.
  • Develop and use collaborative relationships to facilitate the accomplishment of work goals.
  • Identify and understand issues, problems, and opportunities; compare data from different sources to draw conclusions; use effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.
  • Take prompt action to accomplish objectives; take action to achieve goals beyond what is required; be proactive.
  • Deal effectively with others in an antagonistic situation; use appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
  • Effectively manage one's time and resources to ensure that work is completed efficiently.
  • Accomplish tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
  • Set high standards of performance for self and others; assume responsibility and accountability for successfully completing assignments or tasks; self impose standards of excellence rather than having standards imposed.
  • Assimilate and apply new job-related information in a timely manner.
  • Clearly convey information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.
  
  PHYSICAL DEMANDS:
  Light - Exerting up to 20 lbs. occasionally, 10 lbs. frequently, or negligible amounts constantly and may require walking or standing to a significant degree.
  

  	Skill	Required / Desired	Amount	of Experience
  Credentialing experience	Required	2	Years

  High school diploma or equivalent	Required
  Additional training beyond high school	Desired

• About the company

  ObjectWin provides global workforce solutions,ObjectWin,Workforce Solutions,IT Solutions,Staffing and Staffing Industry to meet current and future business demands of our customers.

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