Credentialing Specialist

Healthcare Outcomes Performance Company (HOPCo) is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks. HOPCo is the managing partner of Arizona-based entities, CORE Institute, Northern Arizona Orthopaedics, CORE Institute Specialty Hospital, Michigan-based CORE Institute, and Florida-based Southeast Orthopedic Specialists Clinics and Musculoskeletal Specialty Hospital. Credentialing Specialist As HOPCo continues to grow, we are looking for a Credentialing Specialist to join the Credentialing Team. Please see below for the functions and requirements for this position. Essential Functions Reviews and completes hospital and payor applications for all health care providers. Completes verification forms/letters for outside facilities. Maintains billing insurance grid, provider insurance grid and each individual physician’s spreadsheet up to date on current insurance changes. Tracks and maintains physician licensure(s), certification and CME credits. Maintains practitioner credentialing files. Maintains practitioner electronic file by keeping all applications/licensure current. Maintains all renewal applications for both hospitals/insurances. Has knowledge of Employee Handbook content along with established policies and procedures. Relies on instructions and pre-established guidelines to perform the functions of the job. Assists the Credentialing Supervisor in their job responsibilities/duties when necessary. Education High school diploma/GED or equivalent working knowledge preferred. Experience 3-4 years of Credentialing experience. Requirements Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers. Some knowledge of insurance billing and hospital credentialing a plus. Knowledge Knowledge of the credentialing process. Knowledge of computer systems. Knowledge of credentialing paperwork and timelines. Knowledge of credentialing timelines and regulations. Skills Skill in establishing good working relationships with internal and external customers. Skill in organizing daily work assignments for various providers. Skill in managing multiple work assignments and setting priorities. Abilities Ability to establish good working relationships with internal and external customers. Ability to communicate effectively with physicians, credentialing agencies and staff. Ability to be organized and efficient in daily work activities/projects. Environmental Working Conditions Normal office environment. Some travel within community. Physical/Mental Demands Requires sitting and standing associated with a normal office environment. Some bending and stretching required. Manual dexterity using a calculator and computer keyboard. Seniority Level Mid‑Senior level Employment Type Full‑time Job Function Health Care Provider Hospitals and Health Care #J-18808-Ljbffr