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FIRST CHOICE HEALTH
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| COMPANY INFORMATION: |
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First Choice Health is a Seattle-based, physician and hospital-owned company
serving Washington and the Northwest since 1985. We now serve well over one million
people with our array of products and services. Our Preferred Provider Organization (PPO)
is recognized as the leading independent PPO in Washington State and has a growing
regional presence in Oregon, Idaho, Montana and Alaska.
We occupy a great downtown location, pay competitive salaries and offer a comprehensive
benefits package including medical, dental, vision, health savings accounts, flexible
spending accounts, life and disability insurance, EAP, 401(k), profit sharing, tuition
reimbursement, transportation assistance, credit union and gym membership discounts.
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CREDENTIALING SPECIALIST II - Only Open to Internal Credentialing Employees - Closes 8/2/2010 at 5PM |
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| JOB SUMMARY: |
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According to established departmental policy, procedure, and standards, be responsible for the administration and coordination of First Choice Health Network?s Credentialing Program. |
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| MAIN DUTIES: |
- Coordinates the auditing process of provider credentialing to meet time-sensitive deliverables.
- Validates provider applications for completeness, accuracy and signature.
- Coordinates the provider termination process within the scope of the credentialing program.
- Updates provider credentialing status in Information System.
- Tracks progress of files to ensure submission to Credentialing Committee in a timely manner.
- Collects data and generates weekly reports on specialist productivity.
- Maintains knowledge of and interprets FCH Credentialing Policies and Procedures and American Accreditation Healthcare Commission (URAC) Standards.
- Provides guidance to Credentialing Specialists on more complex credentialing issues.
- Works independently with internal and external customers to research and resolve credentialing related issues.
- Assists in the coordination and performance of all credentialing functions, including intake, primary source verification, documentation, and tracking of credentialing requests, according to national quality standards, with guidance from the Credentialing Supervisor and/or Department Manager.
- Provides process oversight of daily business operations as it relates to resolution of non-responsive providers to credentialing and recredentialing to ensure all efforts are made to keep providers in compliance according to URAC standards and regulatory requirements.
- Assists with credentialing training for new associates, and refresher training for existing associates. Provides input for training materials and job aids.
- Assists in development of "best practice" department policies and procedures and workflows to create and maintain replicable processes within the department.
- Other duties as assigned.
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| REQUIREMENTS: |
- AA Degree or High School diploma or equivalent, and 1-3 years of equivalent related experience in a provider and/or facility credentialing function in a healthcare environment
- Advanced computer skills and related software programs including, but not limited to Word, Excel and Access
- Ability to organize, manage, control work flow and meet deadlines.
- Ability to work independently and provide direction and leadership to department personnel when necessary.
- Ability to interpret and draft procedures.
- Strong written, verbal and interpersonal skills
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| CONTACT INFORMATION: |
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Please submit your resume to jobs@fchn.com.
Additional information about our company may be found on our website
www.fchn.com
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