Interpath Laboratory

Credentialing and Privileging Specialist, Remote for OR, WA & ID Residents

Location US-OR-Pendleton
Job ID
2021-4393
# Positions
2
Category
Administrative/Clerical
Schedule
Full Time, M-F
Bilingual
Not Required
Travel
No

Job Description

Adaugeo Healthcare is seeking a Credentialing and Privileging Specialist who ensures continuous and accurate credentialing and privileging of new and existing physicians and APPs, maintains a centralized credentials file for all providers with accurate and current documentation, complies with all state, federal and health plan requirements, and communicates and coordinates with appropriate clinic personnel to achieve this.

 

 

***Remote for OR, WA and ID Residents Only***

 

Essential Duties and Job Responsibilities:

  • Facilitates all aspects of credentialing/re-credentialing and privileging/re-privileging processes, including enrollment with applicable health plans.
  • Enters and maintains accurate and confidential credential files for each health care provider in applicable credentialing databases to ensure timely renewals.
  • Coordinates receipt of credentialing and privileging applications, and follows up quickly on missing information.
  • Reviews all submitted information for accuracy and identifies problem areas for additional attention.
  • Notifies applicable parties of issues and follows up to ensure prompt resolution.
  • Uses critical thinking skills while performing credentialing to flag incongruent issues or information as they arise.
  • Maintains a positive working relationship with regional and corporate colleagues, and internal and external customers.
  • Performs other duties as assigned.

Performance Requirements:

  • Awareness of demands facing providers in the credentialing and privileging process.
  • Knowledge of privacy laws, regulations and national standards related to health plan credentialing
    and/or facility privileging.
  • Experience updating/maintaining credentialing databases.
  • Strong computer, organizational and communication skills.
  • Ability to develop effective processes and work collaboratively with Corporate and Regional leadership.
  • Ability to take initiative, work independently, resolve problems and meet deadlines.

Minimum Qualifications

Education and/or Experience:

  • Minimum of two (2) years practitioner credentialing and/or privileging experience, or three (3) years administrative experience that demonstrates attainment of the requisite job knowledge skills/abilities in
    a healthcare setting.
  • Bachelor’s degree or higher in health care administration or related area of study preferred.
  • Current certification as a Certified Professional in Medical Services Management (CPCSM), Certified Provider Credentialing Specialist (CPC), or Certified Professional in Healthcare Quality (CPHQ)
    preferred.

About Us

Life at Adaugeo Healthcare Solutions: 
We are a devoted team of professionals, working cohesively to build on our expertise as a work family since 2007.  With a vibrant work culture focused on continually improving people and processes, our curiosity, persistence and positive attitudes are core strengths. We offer a comprehensive benefits package and an ever-evolving learning and development program to foster career and personal growth.  We truly value our employees.

More About Us: 
Adaugeo Healthcare Solutions is part of a family owned and operated healthcare organization, providing collaborative support and corporate oversight to our family of companies.  We are committed to operational excellence and cost-efficient administrative, technical and management services, including:

  • Accounting and Finance
  • Billing and Accounts Receivable
  • Centralized Scheduling
  • Certified Coding
  • Clinic Administration
  • Credentialing and Privileging
  • Data Science and Business Intelligence
  • Human Resources and Payroll
  • IT Infrastructure
  • Purchasing and Materials Management
  • Quality Improvement
  • Recruiting and Sourcing
  • Software Development

Our family of companies also includes Praxis Health, the largest independent medical group in Oregon, and Interpath Laboratory, Inc., the Northwest’s leading, innovative clinical and anatomic medical laboratory with over 90 locations across Oregon, Washington, and Idaho. Our organization has over 50 years of proven success as a multi-specialty healthcare delivery system, thanks to our amazing people who contribute passion, dedication and ingenuity every day.  It’s because of our people that we believe in putting people first!

General Physical Requirements

Mental/Physical Requirements

  • Job duties frequently require intense concentration and attention to detail (up to 65% of work time).
  • Occasional stress related to deadline pressure.

 

Work Environment

  • Office setting at Corporate Headquarters or telecommuting from home office (OR, WA, ID only). No expectations for travel.

Equal Opportunity Statement

EOE Disabled/Veteran

Adaugeo Healthcare Solutions is an Equal Opportunity Employer and provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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