Credentialing Assistant - Summit Medical Group
Full Time
Knoxville, TN 37909
Posted
Job description
Overview:
Summit Medical Group is East Tennessee’s largest primary care organization with more than 375 providers at 82 practice locations in 16 counties. Summit also consists of four diagnostic centers, mobile diagnostic services, eight physical therapy centers, four express clinics, central laboratory, and sleep services center. Summit provides healthcare services to more than 280,000 patients, averaging over one million encounters annually. For more information, visit www.summitmedical.com
In addition to our commitment to the health of our community, our organization is also committed to the health of our employees through our employee Wellness Program. Employees receive a discounted monthly insurance premium if they actively participate in the wellness program. Furthermore, Summit Medical Group hires only non-tobacco users. Pre-employment drug testing will include testing for nicotine, and only candidates who pass the drug test will be considered eligible for employment. Responsibilities:
Summit Medical Group is seeking a Credentialing Assistant to provide administrative support to the credentialing staff to assist in documentation and application process for all providers. This is a full-time opportunity, working Monday-Friday 8:00AM to 5:00PM. This is a remote position but employees must come in office for intial training and then at least once a week on an on-going basis.
Responsibilities: (List does not include all duties assigned)
EXPERIENCE:
About Summit Medical Group
Summit Medical Group is East Tennessee’s largest primary care organization with more than 375 providers at 82 practice locations in 16 counties. Summit also consists of four diagnostic centers, mobile diagnostic services, eight physical therapy centers, four express clinics, central laboratory, and sleep services center. Summit provides healthcare services to more than 280,000 patients, averaging over one million encounters annually. For more information, visit www.summitmedical.com
In addition to our commitment to the health of our community, our organization is also committed to the health of our employees through our employee Wellness Program. Employees receive a discounted monthly insurance premium if they actively participate in the wellness program. Furthermore, Summit Medical Group hires only non-tobacco users. Pre-employment drug testing will include testing for nicotine, and only candidates who pass the drug test will be considered eligible for employment.
About Our Career Opportunity
Summit Medical Group is seeking a Credentialing Assistant to provide administrative support to the credentialing staff to assist in documentation and application process for all providers. This is a full-time opportunity, working Monday-Friday 8:00AM to 5:00PM. This is a remote position but employees must come in office for intial training and then at least once a week on an on-going basis.
Responsibilities: (List does not include all duties assigned)
- Processes initial credentialing and re-credentialing applications of healthcare providers.
- Enter and maintain provider information in the Cactus credentialing database.
- Prepare verification and term letters for Hospital and Insurance companies.
- Contact Medical schools, medical staff offices, licensing agencies and insurance carriers.
- Demonstrate exceptional customer service skills in the performance of work assignments and duties.
- Assist Credentialing Department Manager and Credentialing Department with various Support functions.
- Assist with Payer Enrollment for all Summit group practices.
- Assisting with Hospital and Insurance Re-credentialing applications ensuring information is correct before flagging documents and forwarding to providers to review and complete. Logging and tracking documents to ensure they are returned in a timely manner.
- Maintain the information in the CAQH Database through entering new providers and completing re-attestations when required.
- Assist with periodic audits of credentialing files especially for new providers in the initial credentialing and enrollment phase.
- Run Cactus reports upon request from internal and external customers when required.
- Provide back up when Credentialing Coordinators are out for an extended period. Complete various clerical duties which will include typing correspondence answering phones and filing.
- Maintains strict confidentiality.
- Adheres to all appropriate aspects of the corporate compliance program.
- Assists with special projects, and related work as required.
EDUCATION:
- High School Diploma, or equivalent, required.
EXPERIENCE:
- Prior office experience (including a health care organization, preferred). Intermediate Word, Excel, and Access experience.
- Commercial insurance enrollment and credentialing in a health plan, hospital, or physician practice setting.
- Knowledge of Medicare and Medicaid physician enrollment processes.
- CAQH database experience.
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