Credentialing Assistant

Credentialing Assistant

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This position provides high quality support for credentialing functions within the health plan. Core responsibilities include records management, document management, and customer service as defined in CareOregon credentialing policies and procedures. This position works closely with the Credentialing Specialist and Credentialing Supervisor in the credentialing process to ensure all applications, primary source documentation, and notifications meet regulatory guidelines.

Estimated Hiring Range:

$20.89 - $25.54

Bonus Target:

Bonus - SIP Target, 5% Annual

Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.

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Essential Responsibilities

• Maintain records according to protocol.
• Keep records in a retrievable manner to support regulatory requirements.
• Retrieve records as needed for activities such as document reviews and audits.
• Coordinate and communicate with records management.
• Maintain confidential and time sensitive material.
• Review provider credentialing applications upon receipt and verify requirements are met to start the credentialing process.
• Enter provider information in databases, maintaining accuracy and completeness of provider information.
• Communicate routinely with other departments to ensure records are being processed according to workflows.
• Communicate with providers regarding applications by telephone and in writing.
• Maintain records of applications and credentialing approval letters.
• Maintain a detailed and confidential credentialing system.
• Conduct quality audits of credentialing files.
• Run required reports to support Credentialing team.
• Assist in the verification of healthcare professional’s information with external verification sources, such as Oregon Board of Medical Examiners and other sources as needed.
• Assist Credential Specialists in meeting team goals and deadlines.
• Assist in audit prep for external and internal entities.
• Perform annual and ongoing document reviews.
• Create job aids as needed.

Experience and/or Education

Required

• Minimum 1 year experience in any of the following: Health plan credentialing, medical office, high-production word processing, and/ or work requiring regular use of Access or other databases

Preferred

• Experience with SharePoint and knowledge of medical terminology

Knowledge, Skills and Abilities Required

Knowledge

• Basic knowledge of quality assurance and/or compliance
• Knowledge of or ability to learn the provider credentialing process
• Knowledge of or ability to learn document management systems

Skills and Abilities

• Ability to retain and maintain confidential files
• Strong organizational skills
• Competency with word processing
• Competency with spreadsheet and database management
• Demonstrated personal initiative and good judgement
• Ability to write and communicate verbally effectively
• Ability to work autonomously
• Ability to perform strong attention to detail to ensure accuracy 
• Ability to manage multiple tasks
• Ability to work in a confidential manner with Provider information
• Ability to work as a member of a team in a collaborative manner
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day

Working Conditions

Work Environment(s):         ☒ Indoor/Office    ☐ Community      ☐ Facilities/Security                       ☐ Outdoor Exposure

Member/Patient Facing:     ☒ No                        ☐ Telephonic       ☐ In Person

Hazards:  May include, but not limited to, physical and ergonomic hazards.

Equipment:  General office equipment

Travel:  May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

Work Location: Work from home

We offer a strong Total Rewards Program. This includes