Job description

SUPERVISOR: Chief Compliance Officer HOURS: M-F 8-5, must be flexible
CLASSIFICATION: Part Time/ Hourly/Non-Exempt PRIMARY LOCATION: Multiple

*
QUALIFICATIONS:*

• High School Diploma with 2-3 years of credentialing experience. Baccalaureate degree in Healthcare Management, Business, or related field a plus.
• Preferred in addition to 1-2 years of administrative work in a fast paced, deadline driven environment.

*
JOB SUMMARY: *Responsible for providing support to the credentialing specialist in all day to day activities in credentialing of JRCHC Licensed providers. Provide support as needed in areas of compliance to the Chief Compliance Officer.

*
Essential Job Duties*
CREDENTIALING

• Support the processing and/or explaining credentialing and privileging forms to providers and other licensed certified health care professionals
• Support the maintenance of information, forms and data for credentialed staff members
• Support gathering and entering information, to create and/or update JRCHC Provider state of New York credentialing and re- credentialing forms (i.e. CAQH) for JRCHC providers, Hospitals, agencies and the like
• Support the completion of all necessary forms as required by Medicare, Medicaid, various Insurance Payers, hospitals, and the like for JRCHC providers
• Provide support in initiating primary source verifications (PSV)
• Responsible for auditing and maintaining provider personnel files
• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
• Maintain an internal provider grid to ensure all information is accurate and logins are available
• Complete revalidation requests issued by government payers
• Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid
• Complete re-credentialing applications for commercial payers
• Support the re-credential of current providers with hospitals at which they hold staff privileges

*
COMPLIANCE SUPPORT*

• Consult with the Chief Compliance Officer and management on compliance matters
• Support in the development and information for employee training on compliance policies, practices, and reporting systems
• Provide support in identifying, investigating, and reporting compliance issues, irregularities, and violations
• Provide support to the Chief Compliance Officer in compliance to FTCA, HRSA, DOH and other relevant entities

Job Type: Part-time

Pay: $17.00 per hour

apartamentosquality.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, apartamentosquality.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, apartamentosquality.com is the ideal place to find your next job.