Education and Training:High school graduate or equivalentPrevious credentialing experience preferred
Experience:Minimum three years experience in Managed Care or the Healthcare environment preferredCredentialing experience preferred
Position Summary:Under the supervision of the Director of Network Operations, the Credentialing Representative is responsible for coordinating the credentialing functions for AMHP PA. The Credentialing Representative coordinates all written communication to physicians, hospitals and ancillary providers to assure all credentialing information is complete for presentation to the Corporate Credentialing Department. Performs a variety of secretarial, administrative, and clerical duties for the staff of Provider Contracting & Services.Responsible for the efficient administrative support of the office.
1. Responsible for submitting credentialing packet information to physicians, hospitals and ancillary providers when participation in the AMHP provider network is requested.2. Submits provider information to delegated credentialing organizations for credentialing data elements.3. Assembles provider credentialing materials received for submission to corporate credentialing departments.4. Follows up with Provider Contracting representatives on outstanding items necessary for credentialing.5. Schedules site visits for primary and ob/gyn providers.6. Maintains accurate and complete database of contracted providers credentialed information.7. Forwards provider information to all required corporate departments.8. Communicates openly with Provider Contracting staff and the Credentialing department.9. Maintains strict confidentiality10. Performs other related duties and projects as assigned.11. Adheres to KMHP/AMHP policies and procedures.12. Supports and carries out the Mercy Mission & Values.13. Attends required training on an annual basis.
High school graduate or equivalent
Previous credentialing experience.
Experience in Managed Care or the Heathcare environment