Credentialing Specialist - Phoenix - HOPCO

    HOPCO
    HOPCO Phoenix

    4 days ago

    Description
    Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
    HOPCo is the managing partner of Arizona-based entities, CORE Institute, Northern Arizona Orthopaedics, CORE Institute Specialty Hospital, Michigan-based CORE Institute, and Florida-based Southeast Orthopedic Specialists Clinics and Musculoskeletal Specialty Hospital.
    As HOPCo continues to grow, we are looking for a Credentialing Specialist to join the Credentialing Team. Please see below for the functions and requirements for this position.
    ESSENTIAL FUNCTIONS
    • Reviews and completes hospital and payor applications for all health care providers.
    • Completes verification forms/letters for outside facilities.
    • Maintain billing insurance grid, provider insurance grid and each individual physician's spreadsheet up to date on current insurance changes.
    • Track and maintain physician licensure(s), certification and CME credits.
    • Maintain practitioner credentialing files.
    • Maintain practitioner electronic file by keeping all applications/licensure current.
    • Maintains all renewal applications for both hospitals/insurances.
    • Has knowledge of Employee Handbook content along with established policies and procedures.
    • Relies on instructions and pre-established guidelines to perform the functions of the job.
    • Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.
    EDUCATION
    • High school diploma/GED or equivalent working knowledge preferred.
    EXPERIENCE
    • 3-4 years of Credentialing experience.
    REQUIREMENTS
    • Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers.
    • Some knowledge of insurance billing and hospital credentialing a plus.
    KNOWLEDGE
    • Knowledge of the credentialing process.
    • Knowledge of computer systems.
    • Knowledge of credentialing paperwork and timelines.
    • Knowledge of credentialing timelines and regulations.
    SKILLS
    • Skill in establishing good working relationships with internal and external customers.
    • Skill in organizing daily work assignments for various providers.
    • Skill in managing multiple work assignments and set priorities.
    ABILITIES
    • Ability to establish good working relationships with internal and external customers.
    • Ability to communicate effectively with physicians, credentialing agencies and staff.
    • Ability to be organized and efficient in daily work activities/projects.
    ENVIRONMENTAL WORKING CONDITIONS
    • Normal office environment.
    • Some travel within community.
    PHYSICAL/MENTAL DEMANDS
    • Requires sitting and standing associated with a normal office environment.
    • Some bending and stretching required.
    • Manual dexterity using a calculator and computer keyboard.
    #HOP
    Equal Opportunity Employer

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