• Data / Credentialing Specialist - Full Time - Days

    Mohawk Valley Health System (Utica, NY)


    Data / Credentialing Specialist - Full Time - Days

     

    Department: REVENUE CYCLE

    Job Summary

    Reporting directly to the Director, Revenue Cycle Services, the Data / Credentialing Specialist (DCS) position is responsible for coordinating and maintaining all aspects of insurance credentialing for Mohawk Valley Health System's employed/contracted providers and ensure timeliness and accuracy of documents. General duties are primarily administrative including, but not limited to, tasks such as processing reports, confirming provider's information with accrediting and licensing agencies and maintaining a database of provider information.

     

    Core Job Responsibilities

     

    + Provider Credentialing- works with insurance provider representatives to ensure timely and efficient credentialing process are adhered to. This includes, but is not limited to Delegated Credentialing. The Data / Credentialing Specialist (DCS) is responsible to maintain communication with site managers/coordinators of credentialing requirements are met. Monitors for changes in provider(s) credentialing information and idependently works with the insurance companies to apply the changes.

    + Organizational Skills -The Data / Credentialing Specialist (DCS) must have organization skills to follow up with providers and site managers to ensure timely collection of credentialing documents (ie. CV, License, DEA, Mailpractice) for insurance credentialing purposes. Candidate must have eleveated attention to detail to ensure accuracy of credentialing applications.

    + Support -The Data / Credentialing Specialist (DCS) supports the departments of the revenue cycle and population health by providing guidance and expertise for all credentialing requirements. Additionallythis role will support the needs of the Population Health Management department including, but not limited to, actively engaged reporting, audits, performance activities and/or quality reporting. Is flexible to meet the emergent needs of the population health department by working on special assignments as needed.

    + Technical Skills -The Data / Credentialing Specialist (DCS) must have knowledge of the provider credentialing software to independently make changes, to ensure accuracy of provider information to prevent lost reimbursement.

     

    Education/Experience Requirements

    Required:

    + Associates in Business, Health Administration or Related Field or equivalent experience

    + Minimum 1 year of experience in healthcare provider credentialing, reimbursements and/or customer service experience

    Preferred:

    + Bachelor's degree in Business, Health Administration or Related Field

    + 3+ years of experience in healthcare hospital provider credentialing or reimbursements

     

    Licensure/Certification Requirements

     

    Disclaimer

     

    Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.

     

    Successful candidates might be required to undergo a background verification with an external vendor.

    Job Details

    Req Id 95755

     

    Department REVENUE CYCLE

    Shift Days

    Shift Hours Worked 8.00

    FTE 1

    Work Schedule HRLY NON-UNION-8 HR

     

    Employee Status A1 - Full-Time

    Union Non-Union

    Pay Range $21 - $31.69 Per Hour