Provider Credentialing Specialist 9/2/2016

Logisticare Garden Grove, CA

Company
Logisticare
Job Classification
Full Time
Company Ref #
3983
AJE Ref #
576069287
Location
Garden Grove, CA
Experience
Mid-Career (2 - 15 years)
Job Type
Regular
Education
High School Diploma or GED

JOB DESCRIPTION

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Requirements:
Education:

- Requires a High School Degree or GED

Experience:

- 2-5 years customer service experience

- Prior experience in an Administrative Assistant role, supporting multiple managers and departments

Skills:
- Superior time management and problem solving

- Must posses excellent written and verbal communication skills to facilitate effective communications and correspondence with internal and external management and clients

- Ability to handle multiple tasks and work well under pressure

- Ability to handle sensitive situations with tact and diplomacy

- Ability to read, interpret and apply laws, rules, regulations, policies and/or procedures

- Strong project management and organizational skills

- Must be proficient in Microsoft Word, Excel and Outlook

Competencies:

- Communication, Oral - Ability to communicate effectively with others using the spoken word.

- Communication, Written - Ability to communicate in writing clearly and concisely.

- Customer Oriented - Ability to take care of the customers' needs while following company procedures.

- Decision Making - Ability to make critical decisions while following company procedures.

- Interpersonal - Ability to get along well with a variety of personalities and individuals.

- Organized - Possessing the trait of being organized or following a systematic method of performing a task.

Environmental and Working Conditions:

- Entire work time is conducted in an office setting.

Physical and Mental Requirements:

- Ability to comprehend and execute detailed instructions from management

- Ability to work independently and/or in a team oriented environment

- Must be able to understand and follow complex instructions

- Ability to learn new software applications

Job Description:
LogistiCare is the nation's leading managed healthcare organization specializing in the management of healthcare transportation benefits. LogistiCare s client base consists of state and local government agencies (Medicaid agencies, transit authorities, school boards), managed care organizations and hospitals. LogistiCare is not a provider of transportation vehicles (we do not physically own vehicles). Instead, LogistiCare manages a network of transportation providers and provides the administrative infrastructure to authorize services and provide billing and claims payment functionality allowing LogistiCare to offer a complete outsourcing solution to our clients.

LogistiCare seeks a Credentialing Specialist
to join our growing company.

The Credentialing Specialist ensures contract fulfillment of insurance requirements, credentialing of sub-contractor vehicles and drivers. He/she is the primary contact for assigned Operations Centers in the support and completion of contractual credentialing obligations.

Key Responsibilities include, but are not limited to:

- Handling inbound/outbound mail including information packets and/or contracts for providers

- Typing and/or writing correspondence

- Communicates with DMV via mail correspondence, electronically and verbally

- Submits weekly reports to management staff

- Ensures compliance with applicable federal and/or state laws, regulations, and/or agency rules, contract standards and guidelines, etc

- Verifies provider documents and ensures that they meet contract requirements as well as scan and maintain documents in an electronic filing system

- Establish and maintain good working relationship with LogistiCare employees, transportation providers and other stakeholders

- Ensures accurate and timely data input

- Maintains and manages data accounts in database

- Proactively partners across all departments to manage the timely satisfaction of LogistiCare's obligations under all contract agreements

- Make observations and recommendations for improvement to management / compliance department

- Maintain strong working knowledge of LogistiCare operations and procedures

- Perform other duties as assigned

LogistiCare is an Equal Opportunity Employer.

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