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POSITION SUMMARY:

Responsible for submitting all credentialing and re-credentialing applications and attachments for all services and facilities within PruittHealth.

WORKING RELATIONSHIPS:

Directly Reports to: Director of Managed Care Contracts

ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES:

• Review and process incoming and outgoing paperwork, including directory updates, provider credentialing applications, demographic changes of services and other related forms.

• Provide office, project management and data analysis support.

• Maintain a comprehensive database of all facilities and payers with updated information regarding credentialing and re-credentialing

• Maintain a file with updated copies of all documents required for credentialing of all PruittHealth services.

• Answers incoming telephone inquiries from PruittHealth entities and payers regarding contracts and credentialing issues.

• Work closely with all PruittHealth entities and educate on the requirements of credentialing and re-credentialing.

• Support the Payer Relations with reports and updates regarding participation status with all payers.

• Maintain corporate standard time frame for completion of credentialing applications.

• Perform special projects upon request

• Excellent Communication, Customer Service and Time Management Skills

• Handles any additional duties as assigned by Management

ESSENTIAL SKILLS AND COMPETENCY:

• Ability to multi-task and handle consistent workflow

• Ability to think critically and work independently

• Attendance – must maintain timely, regular attendance.

• Communicates well with clients, vendors, fellow partners, visitors and family members providing warm and friendly greeting and an approachable attitude. Answers questions when appropriate in a professional manner.

• Develop and foster relationships

• Effective oral, written and telephone skills

• Excellent customer service and communication skills

• Initiative to follow-up on pending issues and organize and assign work

• Must be able to maintain confidentiality regarding company proprietary information

• Must have the ability to relate professionally and positively and work cooperatively with external partners and other employees at all levels

• Professional appearance. Dresses according to Company’s Dress Code Policy

• Proficiency in MS Office Suite (Excel, PowerPoint, Word, Outlook, Teams, etc.)

• Work within scope of job requirements

ESSENTIAL ADMINISTRATIVE FUNCTIONS:

• Attends and participates in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification as required.

• Attends and participates in mandatory in-services.

• Complies with corporate compliance program.

• Performs other related duties as necessary and as directed by supervisor.

PREFERRED SKILLS AND EXPERIENCE:

• Minimum 2 years’ experience in healthcare contract credentialing or equivalent

**Family Makes Us Stronger.** Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

We are eager to connect with you! **_Apply Now_** to get started at PruittHealth!

_As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status._