Calculators, Communication Skills, Computer Systems, Corporate Policies, Data Quality, Detail Oriented, Fax Machines, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Providers, Keyboards, Legal, Maintain Compliance, Mathematics, Microsoft Excel, Office Equipment, Operations Processes, Regulations, Regulatory Compliance, Software Administration, Team Player, Word Processing
Summary: Verifies and maintains the professional credentials of individuals, especially healthcare providers, to ensure they meet regulatory and organizational standards.
Essential Duties and Responsibilities: Other duties may be assigned to meet business needs
• Compile, process and maintain credentialing applications
• Enter, update and maintain accurate data in provider & agency databases
• Verifies education and licenses through source verification
• Monitor & professionals and agency records to ensure compliance with all regulatory and accrediting standards.
• Monitor license and credential expiration dates and advise staff on renewal procedures to prevent lapses.
• Respond to inquiries and provide information to requesting agencies or individuals as required by law
• Verify, upload and enter insurance policies into client benefit assignments as requested
• Comply with federal, state and company policies, procedures and regulations
• Maintains confidentiality of all information and complies with HIPAA regulations
• Demonstrates knowledge of and supports Westbrook Health Services mission, vision, values, policies and procedures, operating instructions, confidentiality standards and code of ethical behavior.
Qualification Requirements:
• Excellent attention to detail.
• Able to use basic office machines such as computer system, word processing, excel, calculators and fax machine.
• Able to communicate clearly and accurately with a variety of individuals in order to convey and received information effectively.
• Must work well in a team environment
• Work with staff, consumers and others in a professional, cooperative ethical respectful and effective manner.
• Ability to work with a diverse group of people
Education and/or Experience: High School Diploma or GED; prior computer/PC experience
using computerized billing systems is preferred, but not required. Incumbent must also possess
basic math Skills. Must pass Criminal Investigation Background and DHHR background checks.
Physical Requirements: 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. Mobility
and ability to sit for long period of time, use a standard computer keyboard, calculator and telephone.
Ability to bend reach and lift up to 10 pounds are required in this position.
Requirements
Education and/or Experience: High School Diploma or GED; prior computer/PC experience
using computerized billing systems is preferred, but not required. Incumbent must also possess
basic math Skills. Must pass Criminal Investigation Background and DHHR background checks.
Physical Requirements: 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. Mobility
and ability to sit for long period of time, use a standard computer keyboard, calculator and telephone.W
WESTBROOK HEALTH SERVICES