1. Maintains credentialing data in the Electronic Health Record (EHR) by following established standards by the state, regulatory bodies and accrediting organizations.
2. Tracks expiration dates of licensures and notifies appropriate individual(s).
3. Processes enrollment applications and maintains staffing reports for third party insurance payors -Magellan, VO, Medicaid, Medicare, etc.
4. Manage third party audit processes.
5. Manage quarterly, yearly and adhoc HR audits.
6. Develops, monitors and maintains various spreadsheets.
7. Conduct employee feedback interviews (exit and entrance and supervisor) and completes summary report for the management team.
8. Serves as employee Unemployment Insurance Coordinator.
9. Works closely with other HR employees and Quality Improvement.
10. Monitors and maintains Contracts for Service files on all contractors, requests required documentation, and sends renewal notices.
11. Duties may also include: mailing out forms for verification, review of forms and follow up by phone to ensure completeness of information.
12. Performs other duties as required to meet program and departmental goals and objectives or as assigned by management.
KNOWLEDGE, SKILLS, AND ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Specific competencies required are identified on a department/program specific basis and identified in each employee’s Competency Checklist. The following are general and apply to all positions with this title.
EDUCATION and/or EXPERIENCE
Required: Bachelors degree and two years experience in Human Resources.
Specific experience may substitute for the required education. Intermediate to advanced skills in Microsoft Word, Excel, and Outlook. Excellent communication skills, multi-tasking ability and a demonstratable customer service attitude with strong work history are critical.
Strongly Preferred: Minimum of 1 year of recent Medical Credentialing experience.
Requires regular and on time attendance to adequately and efficiently meet the expectations of position.
Consistently demonstrates courtesy towards staff and fellow co-workers; and treats others with respect and dignity. Ability to effectively participate in cross functional teams.
Ability to read, analyze, and interpret spreadsheets and accreditation requirements. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and potential applicants.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stand; walk; and stoop, kneel, crouch, or crawl. The employee must regularly lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, peripheral vision, and ability to adjust focus.
WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.
Pay Rate: $13.30 to start. Up to $14.30/hour after 90 day successful evaluation.