http://www.watsonclinic-jobs.com/feeds/medicare-Florida-jobs/ Custom RSS Feed for medicare-Florida-jobs Fri, 10 Sep 2010 10:09:08 GMT en-us /sites/watsonclinic/images/watson_banner.gif http://www.watsonclinic-jobs.com/feeds/medicare-Florida-jobs/ 720 Job Title: Credentialing Specialist - Full Time
Company Name: Watson Clinic
Employment Type: Full Time
Location:LAKELAND, FL, United States
Department: Credentialing
Salary: Highly Competitive
Shift/Hours: 8 hrs per day/M-F
Hours/Pay Period: 80
Degree Required:A.A.
Job ID: 0995.2010.01755
Date Posted: Aug 30, 2010
Years Experience: 3
Category:Clerical
Location:Edgewood
Note: Please read the complete description below before applying for this job.

Complete Description

Education: Associates Degree or equivalent preferred.

Experience: A minimum of 2 years experience in credentialing for a physician organization or hospital medical staff. Knowledge of NCQA, JCAHO and Managed Care credentialing requirements. Maintains strict confidentiality of credentialing information.

Other Requirements: Proficient computer skills (word, excel, access). Excellent verbal and written communication skills. Attention to detail and accuracy.

Responsibilities:

* Serves as the liaison to third parties, Medicare & Medicaid to ensure that all eligible Clinic practitioners are identified as active providers.
* Coordinates the credentialing sign-up process for new practitioners.
* Coordinates the credentialing and recredentialing of providers for LSDC.
* Maintains computerized (Cactus) and hard copy credentialing files for all practitioners.
* Coordinates audits of credentialing and medical records with Managed Care Organizations.
* Maintains the MCO provider participation grid to flag any problems with practitioners and notifies appropriate parties.
* Coordinates obtaining initial hospital applications for the medical staff. Follows up to ensure completion and offer to gather needed information in time to be reviewed by hospitals Credentials Committee. Completes hospital reappointment applications in a timely manner and processes to ensure no break in providers hospital privileges.
* Monitors practitioners enrollment with Medicare/Medicaid and MCO's to ensure proper participation date.

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