Provider Enrollment and Credentialing Representative
Sonic Healthcare USA

Job Info

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Job Functions, Duties, Responsibilities and Position Qualifications:

Quality is in our DNA -- is it in yours?

You are a superhero when it comes to patient specimens. You've got problem-solving instincts, a passion for patient care, and the drive to keep things running smoothly. You're also looking for great benefits, the support of an all-star team, and an opportunity to grow your career.

Join our front line of #HealthcareHeroes! Our mission is to advance the health and wellbeing of our communities as a leader in clinical laboratory solutions.

In this role, you will:

The Provider Enrollment & Credentialing Representative will be accountable for the initiation of new credential files, ensuring the completeness of a new application as the first step in the credential's verification process, and participating in verification of credentials through correspondence, phone contact, internet sites and any other third-party vendor.

***Remote Opportunity***

Full-time: Benefit Eligible

Days: Monday - Friday

Hours: 8:00 AM - 4:30 PM

• Initial credentialing and re-credentialing of physicians.
• Obtains Medical Licenses as required, as well as ensures that all Aurora Medical staff meet and maintain active licensure.
• Oversee the maintenance of all certifications required to successfully license and credential all physicians with the exception of the laboratory's CLIA licenses.
• Coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
• Conducts thorough background investigation, research and primary source verification of all components of the application file.
• Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
• Prepares credentials file for completion and presentation to Entity Credentialing Committees, ensuring file completion within time periods specified.
• Responsible for CAQH files for providers to ensure completion and maintain revisions/updates.
• Processes requests for Provider Enrollment ensuring compliance with criteria outlined in descriptions for both commercial and Government payers.

All you need is:

• Bachelor's Degree or the equivalent years of experience.
• Four years related experience; or equivalent combination of education and experience.
• Ability to solve complex problems to support the planning, organizing, and coordinating of provider payer credentialing.
• Knowledge of medical terminology, insurance billing, credentialing and licensing processes as demonstrated by work experience and education.
• Must be able to effectively respond to questions from managers, employees, and outside entities.
• Evidence of the practice of a high level of confidentiality

Company:

Sonic Anatomic Pathology

We'll give you:

• Appreciation for your work
• A feeling of satisfaction that you've helped people
• Opportunity to grow in your profession
• Free lab services for you and your dependents
• Work-life balance, including Paid Time Off and Paid Holidays
• Competitive benefits including medical, dental, and vision insurance
• Help saving for retirement, with a 401(k) plus a company match
• A sense of belonging - we're a community!

We also want you to know:

This role will have routine access to Protected Health Information (PHI). Employees will be trained on reasonable safeguards and are expected to maintain strict confidentiality, as well as abide by all applicable privacy and security standards. Employees are expected only to access PHI when it is required to fulfill job duties.

Scheduled Weekly Hours:
40

Work Shift:

Job Category:
Administration

Company:
Aurora Diagnostics LLC

Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This job has expired.