This position is: Full Time
Position Location: Lake Charles, LA
JOB TITLE: Credentialing Supervisor
GENERAL SUMMARY OF DUTIES: The Credentialing Supervisor maintains
and transmits pertinent credentialing information for each of the practitioners
at Imperial Health to ensure that partners and mid-level providers continuously
meet the credentials, standards, and requirements of hospitals, entities and
healthcare networks and coordinates these efforts with Credentialing
Coordinator(s) within the credentialing department.
REQUIRED: Assistant Administrator
EXERCISED: Credentialing Coordinator
- Maintain a current
credentials file on all practitioners and accurate, up-to-date information
in an electronic database (e.g. CAQH), including malpractice summary.
- Responsible for obtaining upgrades
to the provider database as needed.
- Facilitate and maintain
credentialing and re-credentialing applications for the hospitals, health
plans and other facilities, as appropriate, for all practitioners
affiliated with Imperial Health.
- Ensure that all
practitioners meet the requirements at all times for participation in health
plans, including Medicare and Medicaid enrollment and assists with
requests for revalidation.
- Track, record, and file
current medical licensure, DEA, CDS, CME, certifications, and malpractice
insurance for all practitioners and provide such to hospitals, health
plans, and other facilities as appropriate.
- Facilitate the renewal of medical
licensure, DEA, and CDS.
- Submit malpractice insurance
applications for all practitioners and facilitate payment of appropriate
- Notifies malpractice carrier
of departing practitioners and requests refunds accordingly.
- Transmit and disseminate
confidential information regarding current practitioners, locum tenens,
and those who have resigned from Imperial Health to hospitals, health
plans, malpractice carrier, and other facilities as appropriate.
- Credential physicians for
locum tenens assignments within Imperial Health and/or Urgent Care
Centers. Prepare a profile of the covering provider and send to
appropriate departments for review.
up-to-date practitioner listing of payor network participation on Imperial
for and participate in annual audits by PPO Plus of credentials files and
Credentialing Policies and Procedures. Provide documentation of review by
Physician Reviewer and consideration and action taken by Compliance
Committee for each physician.
- Facilitate and maintain
credentialing and re-credentialing applications of practitioners who have
privileges at the Imperial Health
Endoscopy Surgical Center.
- Responsible for submitting
re-credentialing applications for the Imperial Health Endoscopy Surgical
Center to payor networks for continued participation.
for coordinating and covering scheduled and unscheduled absences of Credentialing
for monitoring timely submission/completion of overall credentialing tasks
with deadlines and/or expiration dates (e.g. licenses, payor/facility affiliations
- Other duties as assigned as
SKILLS & ABILITIES:
possess strong organizational and communication skills
to professionally convey the urgency of time-sensitive requests
to meet deadlines
well under pressure
to promote teamwork
Associates Degree in related field preferred. Minimum high school diploma or equivalent with experience as listed below.
- Minimum of three (3) years of Business Office/Administrative experience in a medical office/facility setting or
- Minimum of two (2) years in supervisory role in a medical office/facility setting.