Provider Credentialing Specialist 9/2/2016
Garden Grove, CA
JOB DESCRIPTIONAPPLY Requirements:
- Requires a High School Degree or GED
- 2-5 years customer service experience
- Prior experience in an Administrative Assistant role, supporting multiple managers and departments
- 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
- 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
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.