Credentialing Specialist

August 2, 2017

Company Name:
Northwest Health Services

Title of Position:
Credentialing Specialist

Work cooperatively with Northwest Health Services’ providers and personnel to carry out the goals and objectives of Northwest Health Services, Inc., according to established policies and procedures. Will treat others respectfully whether it is a patient, fellow employee, member of management, customer, vendor or visitor to our premises. Responsible for maintaining standardized credentialing packets for each provider. Responsible for initiating contact with new providers to complete standardized credentialing packet. Responsible for timely re-credentialing existing providers with all insurance plans as needed or when requested. Responsible for sending re-credentialing packets to providers with appropriate follow-up. Follow-up with insurance plans to insure that applications are being processed appropriately. Develop a process for tracking and monitoring enrollment processes Responsible for notifying provider/clinic when enrollment is complete. Act as the liaison between the insurance network/Medicare/Medicaid and Northwest Health Services’ patients/providers/staff. Maintain credentialing files insuring that correspondence to and from insurance network/Medicare/Medicaid is filed appropriately. Maintain managed care membership lists and track numbers for UDS reporting at administration’s request. Assist patients and NHS’ staff with credentialing questions and/or concerns. Work closely with the HR department sharing information and documents for our new providers. Complete and maintain Excel spreadsheets for credentialing records, insurance plans, and management as required. Assist with Meaningful Use and complete Meaningful Use enrollments. Must comply with the provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Perform related work as required.

Link to Application:

Name of Contact:
Heather Miller, Recruiting & Onboarding Specialist

Email Address of Contact: