Payer Enrollment & Privileging Specialist
Company: Kelly Services
Location: Austin
Posted on: April 9, 2021
|
|
Job Description:
Kelly Services is currently seeking Payer Enrollment &
Privileging Specialist for one of our top medical customers in
Austin, TX Zipcode: 78746 Pay Rate:--$ 17.00 ----Working Hours:
7am-8:30am and work an 8 hour shift.Training 8am - 4:30pm Monday -
Friday--Position is remote to start but will require them to be in
the office at some point once office is back to open.Duration:
Possible contract to hireResponsibilities: Collaborates with a
third party/external payers and facilities/privileging agent to
ensure both payer enrollment & privileging process is completed as
required. Ensures all provider enrollment & privileging
verification is performed in accordance with regulatory and
accreditation standards as well as internal FMCNA policy and
procedure. Performs audits of both the internal FMCNA Provider
Database and FMCNA provider information compiled by the external
payer and facility credential verification agent to ensure that
credential verification is completed in a timely manner according
to all regulatory and company requirements.PRINCIPAL DUTIES AND
RESPONSIBILITIES:--- Under limited supervision, applies
considerable payer enrollment & privileging knowledge to perform a
broad range of tasks which include but are not limited to------
Contacts are frequently with individuals representing other
departments, and/or representing outside organizations. Contacts
involve obtaining or providing information or data on matters of
moderate importance to the function of the department or which may
be of a sensitive nature.--- May escalate issues to supervisor for
resolution, as deemed necessary.--- Performs provider/practitioner
payer enrollment & facility privileging tasks to completion by
completing necessary applications, documentation, and gathering the
needed information to ensure the provider/practitioner secures
privileges and participation.--- Utilizes knowledge regarding
national accreditation standards, internal medical staff bylaws and
other related policies and regulations to perform functions
pertaining to the provider/practitioner privileging process for the
FMS Division. This includes but is not limited to:o Completing and
processing all initial and re-credentialing payer & facility
privileging applications for new providers/practitioners and
credential verification applications for existing
providers/practitioners in a timely and accurate mannero Conducting
follow up as needed, acting as the primary liaison for FMCNA
locations, practitioners, and the FMCNA third- party privileging
agent to ensure that all enrollment & privileging is completed
within the required timelines and that each provider/practitioner
meets federal and state regulations as well as FMCNA internal
requirementso Maintaining and updating the database on individual
provider/practitioner enrollment & privileges' status, tracking
pending/completed applications, and maintaining a complete and
accurate database of historical applications. Provides regular
reports and updates to pertinent FMS field operations management
and Director Operations Monitoring.o Communicating with
practitioners regarding payer & facility status, providing updates
and obtaining additional information as required.o Update
practitioner CAQH profile online or any additional NCQA primary
source verifications upon initial credentialing for both payer or
facility, as needed--- Educates and informs FMS field staff
responsible for reporting new practitioners regarding their
responsibilities in the payer & privileging process. Explains the
payer & privileging requirements, practitioner specific
information, regulations and industry standards for privileging of
health care providers and other information as applicable---
Continually audits and analyzes the privileging process to identify
deficiencies in controls and to identify process/workflow issues
recommending improvements to manager and implementing if
approved.--- Review internal Provider Database information and
database of FMCNA provider information to take appropriate action
where required to correct areas inaccurate data on re-credentialing
and effective dates for payers & facilities or any other data
point, such as license expirations, malpractice expirations, etc to
ensure data integrity--- Responsible for generating various
standard and ad hoc reports from database:o Prepares project status
reports as required, detailing progress of credential verification
status of individual practitioner credential applications for each
FMS Division, and reporting variances and trends in the privileging
process as identified to the Director Operations Monitoring.o
Prepares reports detailing credential verification issues to
pertinent field staff and credential verification agento The
monthly provider/practitioner payer & privileging status report for
review by Director Operations Monitoring.--- Review and comply with
the Code of Business Conduct and all applicable company policies
and procedures, local, state and federal laws and regulations.---
Assist with various projects as assigned by direct
supervisor.--Qualifications: --- High School Diploma required;
Associate's Degree desirableEXPERIENCE AND REQUIRED SKILLS:--- 2 -
4 years' related experience in credential verification, facility
privileging, or in a Physician practice/Medical office or other
similar experience in a healthcare setting preferred.--- Strong
detail orientation required, with the ability to administer
multiple tasks and prioritize.--- Excellent verbal and written
communication skills.--- Ability to positively interact with
Providers, hospital personnel, and other internal and external
contacts.--- Perform work at a high level of accuracy and
timelines.--- Attention to confidentiality and regard for
protecting confidential and sensitive information--- Advanced level
skills with Microsoft Access, Excel, and Word.--- Strong problem
solving and time management skills with the ability to consistently
work in a fast-paced environment.Strong Excel, data-base
management, and document storage and management skills--Position is
a contract to start with possibility of becoming permanent in the
future based on business need and candidate performance. Position
is working with credentialing physicians and ensuring they have
privileges for visiting hospitals where the patients are at.Looking
for a candidate that can project manage and follow through the
whole process. Need someone that is task oriented and has ability
to connect the dots. Candidate is going to be using 2 to 3
different databases at once. If they have InteliSoft (credentialing
software) experience that would be a plus but if not we will train
them on this software.. Hours for the first 2 weeks will be
8:00am-4:30pm for training and then after training, they can pick
their start time----As a Kelly employee, you'll have access to
world-class perks, including:
Keywords: Kelly Services, Austin , Payer Enrollment & Privileging Specialist, Other , Austin, Texas
Click
here to apply!
|
Didn't find what you're looking for? Search again!
Other Other JobsFood Store Shopper and Delivery Driver Description: As a driver with Shipt, you are a bearer of good things - from groceries, to gadgets, to home decor. You simply drive up to stores, pop your trunk to pick up orders, then deliver to your customers' door (more...) Company: Shipt Location: San Marcos Posted on: 04/17/2021 RN House Supervisor Nursing Admin Description: DescriptionSummary: Supervises and coordinates activities of nursing personnel in multiple Company: CHRISTUS Health Location: San Marcos Posted on: 04/17/2021 Retail Sales Associate Description: Company DescriptionNOW TRENDING: Careers at SKECHERS.Join the thousands of innovators, advocates and forces who are making an impact every day at one of the biggest footwear brands in the world. Whether (more...) Company: Skechers Location: San Marcos Posted on: 04/17/2021 Fire Control Specialist (13J) Description: JOINT Automated Systems are tools that help provide strategic coordination and situational awareness at the tactical levels of combat. As a Fire Control Specialist, your primary responsibility will be (more...) Company: Army National Guard Location: San Marcos Posted on: 04/17/2021 Dedicated - $1,100+/wk - No unloading! Description: Job DescriptionMarten has a great dedicated opportunity that keeps you close to home, so Company: Marten Transport Location: San Marcos Posted on: 04/17/2021 Be a Shipt Shopper, AKA paid grocery pro Description: Shipt is a membership-based marketplace that helps people get the things they need, like fresh produce and household essentials, from stores they trust. Help people save time and have fun while you're (more...) Company: Shipt Location: San Marcos Posted on: 04/17/2021 Registered Nurse ICU MedSurgical A Description: DescriptionSummary: Registered professional nurse who assesses, implements or delegates, plans, and evaluates total nursing care and functions in accordance with established Company: CHRISTUS Health Location: San Marcos Posted on: 04/17/2021 HIRING: Team Drivers - 10 Best Companies for Team Drivers Description: Hiring CDL drivers in your area. Apply once and choose a trucking job that works for you. Get home when you want to, and get paid what you deserve Company: Live Trucking Location: San Marcos Posted on: 04/17/2021 Optometrist Description: Job DescriptionCompany Description About Us: Our practice is looking for a dedicated Optometrist with strong diagnostic skills and a passion for delivering a great patient experience. Our Optometrists (more...) Company: National Vision Location: San Marcos Posted on: 04/17/2021 CDL A Truck Driver Description: Company Driver - 75,500k, Dry Van/Driver Tailgate - REGIONAL/OVERNIGHTS Requisition ID: 784 For More Information, Contact Tonya 1.888.765.5360 Pay Benefits Full-time CDL-A Company: Cardinal Logistics Location: San Marcos Posted on: 04/17/2021 |