Credentialing Support Assistant in Orange at Prospect Medical Systems

Date Posted: 2/18/2021

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    600 City Parkway West
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    2/18/2021
  • Job ID:
    17962

Job Description



Credentialing Support Assistant

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Credentialing Support Assistant this position performs administrative/clerical duties for the Credentialing Department.



Job Responsibilities/Duties

  • Responsible for the generating, mailing, tracking, and subsequent processing of HDO re-credentialing applications.  All re-credentialing files are to be completed within a 36 month timeframe.  Update new information as received via re-credentialing process.
  • Process Initial and Re-Credentialing Applications as they come in (includes: reviewing, data entry, assigning to Credentialing Coordinators and following up for missing documents)
  • Track Re-Cred Applications received using an excel spread sheets and Morrisey notes
  • Coordinate with the Contracting Department to confirm and track terminated and pending terminated providers
  • Track the status of Initial Credentialing Applications using an excel spread sheet
  • Answer ad-hoc questions regarding the credentialing status of providers (phone calls and emails)
  • Submit initial provider profiles to appropriate Contracting department within one (1) day after Committee approval.
  • Handle in-coming Department phone calls.
  • Distribute in-coming mail.
  • Send credentialing files to the CVO and track progress using excel spread sheets and Morrisey notes
  • Ensure all due recreds are returned on a timely manner and ensure Performance Standards are being met
  • Follow-up on providers responsiveness/issues found by the CVO
  • Assign the CVO returned files to the coordinators immediately after return and ensure timely completion by using the report
  • Notifies management of any expirables that are in jeopardy of becoming delinquent. Ensures accuracy of the expirables database and sends out reminders to members per policy.
  • Follows up in obtaining missing information.
  • Maintain daily logs to reflect correct reporting.
  • Responsible for the generating, mailing, tracking, and subsequent processing of provider initial and re-credentialing applications. 
  • All re-credentialing files are to be completed within 36 month timeframe. 


Qualifications

Minimum Education: High school diploma or equivalent. 

Minimum Experience: Previous credentialing experience with at least one year IPA/Medical Group experience preferred.

Req. Certification/Licensure: None.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

Prospect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol.  Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm.  For this reason, we require applicants to pass a screening for drug use as a condition of employment.  This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.



How to Apply

To apply for this role, or search our other openings, please visit   http://pmh.com/careers/  and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm



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