Job Information
TEKsystems Credentialing Coordinator in Fresno, California
Description:
Position:
Supporting the Provider Credentialing department, this full-time position is directly responsible for coordinating provider demographic data and ensuring demographic changes are processed timely and accurately along with ensuring accuracy of data as well as meeting all regulatory requirements as applicable
Cleaning up spreadsheets of 2000 physicians with missing information ranging from contact information to tax ID numbers
Researching via google, other staff, various internal sites for information
ESSENTIAL DUTIES AND RESPONSIBILITIES
Serves as a key liaison between health plans, providers and internal staff to process, review and communicate provider demographic data
Maintains provider database and demographic data for health plan rosters/directories, ensuring that data accurately reflects provider participation on various panels.
Responsible for communicating demographic changes to health plans and internal staff via template report.
Generates reports, both routine and ad hoc to appropriate staff or delegated groups
Assists health plans with quarterly data validation queries
Responds to health plan inquiries related to provider demographic data
Accountable for optimal usage of the existing data systems and applications
Data mining, summarizing, validation and integrity of provider demographic data
Responsible for supporting Provider Credentialing initiatives including data entry, roster audits and overall provider roster.
Actively participate in health plan meetings, serving as the IPA's representative
Actively participate in cross-functional projects having an impact on Provider Credentialing
In the spirit of teamwork, employees are expected to follow any other job-related instructions and to perform any other job-related duties as requested.
Data entry within spread sheets to clean up blank data from the data transfer
Auditing the spreadsheet for incomplete date and errors
Requirements:
Detail oriented
Ability to take direction well
Ability to work independently
Comfortable with PC
Familiarity with patient medical records
2 years clinical office experience
Epic EHR experience desirable
Additional Skills & Qualifications:
Minimum requirements: strong data entry experience, experience with excel and spreadsheets, someone solution oriented and takes initiative in a project to reach the goal
• High School diploma/GED equivalent required.
• Three years' experience in data analytics to include at least one year of experience in a healthcare setting preferred.
• Experience and working knowledge of clinic operations.
• Proficient user of MS Office Suite primarily Microsoft Excel.
• Working knowledge of managed care environment and associated lines of business such as HMO/Commercial/Medicare/Medicaid.
• Knowledge of database software applications is a plus.
Experience Level:
Intermediate Level
#prioritywest
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.