Credentialing Specialist Job at PruittHealth, Norcross, GA

S2xqUlg5NGUwRkwwTU40Uk1nNTVieFNvNGc9PQ==
  • PruittHealth
  • Norcross, GA

Job Description

**POSITION SUMMARY:** Responsible for submitting all credentialing and re-credentialing applications and attachments for all services and facilities within PruittHealth. **WORKING RELATIONSHIPS:** Directly Reports to: Director of Managed Care Contracts **ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES:** - Review and process incoming and outgoing paperwork, including directory updates, provider credentialing applications, demographic changes of services and other related forms. - Provide office, project management and data analysis support. - Maintain a comprehensive database of all facilities and payers with updated information regarding credentialing and re-credentialing - Maintain a file with updated copies of all documents required for credentialing of all PruittHealth services. - Answers incoming telephone inquiries from PruittHealth entities and payers regarding contracts and credentialing issues. - Work closely with all PruittHealth entities and educate on the requirements of credentialing and re-credentialing. - Support the Payer Relations with reports and updates regarding participation status with all payers. - Maintain corporate standard time frame for completion of credentialing applications. - Perform special projects upon request - Excellent Communication, Customer Service and Time Management Skills - Handles any additional duties as assigned by Management **ESSENTIAL SKILLS AND COMPETENCY:** - Ability to multi-task and handle consistent workflow - Ability to think critically and work independently - Attendance - must maintain timely, regular attendance. - Communicates well with clients, vendors, fellow partners, visitors and family members providing warm and friendly greeting and an approachable attitude. Answers questions when appropriate in a professional manner. - Develop and foster relationships - Effective oral, written and telephone skills - Excellent customer service and communication skills - Initiative to follow-up on pending issues and organize and assign work - Must be able to maintain confidentiality regarding company proprietary information - Must have the ability to relate professionally and positively and work cooperatively with external partners and other employees at all levels - Professional appearance. Dresses according to Company's Dress Code Policy - Proficiency in MS Office Suite (Excel, PowerPoint, Word, Outlook, Teams, etc.) - Work within scope of job requirements **ESSENTIAL ADMINISTRATIVE FUNCTIONS:** - Attends and participates in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification as required. - Attends and participates in mandatory in-services. - Complies with corporate compliance program. - Performs other related duties as necessary and as directed by supervisor. **PREFERRED SKILLS AND EXPERIENCE:** - Minimum 2 years' experience in healthcare contract credentialing or equivalent **Family Makes Us Stronger.** Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference. We are eager to connect with you! **_Apply Now_** to get started at PruittHealth! _As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status._

Job Tags

Contract work,

Similar Jobs

True North Recruiters

Insurance Broker- COMMISSION BASED SALES Job at True North Recruiters

 ...and technology. You bring the integrity, work ethic, and coachability. This is a...  ...clients are requesting information by either filling out a form via direct mail, calling a 1-800 number,...  ...needed to grow their business from home at their own pace. #remote #workfromhome... 

Uniti Med

Travel Nurse RN - Psychiatric - $1,840 per week Job at Uniti Med

 ...Uniti Med is seeking a travel nurse RN Psychiatric for a travel nursing job in Kansas City, Missouri. Job Description & Requirements ~ Specialty: Psychiatric ~ Discipline: RN ~ Start Date: 02/23/2026~ Duration: 13 weeks ~36 hours per week ~ Shift: 12... 

United Guard Security, Inc.

Unarmed Security Officer Job at United Guard Security, Inc.

 ...United Guard Security is seeking an Unarmed Security Officer to become an integral part of our team. The selected individual will be securing and patrolling an apartment building located in Downtown, Los Angeles. Contact: Luz (***) ***-**** Location: Downtown,... 

The 2nd You

House Cleaner Job at The 2nd You

 ...client one project at a time. **NOTE: All services are catered to each clean and their needs. We are more than a surface cleaner. We are proud to offer the following services; including but not limited to: Cleaning - can range from a quick tidy... 

Energy Trust of Oregon

Project Manager, Measure Development Job at Energy Trust of Oregon

 ...Energy Trust is recognized as one of the 100 Best Nonprofits to Work For in Oregon. Our Vision Clean, affordable energy for...  ...an office space at the Portland, OR location Work from home laptop provided Read more about our benefits here APPLICATION...