Credentialing Specialist I in Orange Park at Parallon

Date Posted: 8/10/2019

Job Snapshot

Job Description

Parallon believes that organizations that continuously learn and improve will thrive. That’s why after more than a decade we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.

We are a wholly owned subsidiary of HCA, a Fortune 100 company with more than 200,000 employees and one of the nation's leading providers of healthcare services, operating over 170 locally managed hospitals and over 100 freestanding surgery centers in 20 states and the United Kingdom. HCA has been named one of the world's most ethical companies for eight years in a row. At HCA, we are driven by a single goal: the care and improvement of human life.
Job Summary

This position will be responsible for undertaking quality assurance monitoring of regional credentialing services. Excellent communication, high integrity, ability to work with sensitive information, and relationship building skills are required. As requested, may be expected to assist with other tasks/projects. Compliance with HCA policy and procedure, Federal and State regulatory, and accrediting agencies is required.
Key Responsibilities

  • Efficiently navigate within HCA’s centralized credentialing database (Cactus) to be able to analyze data and images
  • Detailed knowledge of HCA’s centralized credentialing policies and procedures to assure that services provided are in compliance
  • Detailed  knowledge  of  HCA’s  flagging  process  to  assure  that  flags  are  thoroughly documented and escalations are tracked accurately.
  • Ability to work with multiple computer monitors to analyze credentialing forms, data, and images and accurately enter quality assurance statistics into standard quality assurance database tool.
  • Compliance with HCA policy and procedures, Federal and State regulatory and accrediting agencies as required.

Job Requirements

Education and Experience

  • Bachelor Degree preferred
  • Minimum one-year experience in healthcare credentialing (i.e., healthcare facility, managed care setting, credentials verification organization, or Medical Staff Office) preferred
  • Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance preferred
  • Understanding of professional telephone etiquette
  • Able to work without daily supervision (monitoring through reporting and supervising through use of technology)

Benefits of working at Parallon
Our benefits package allows you to select the options that best meet the needs of you and your family. Benefits include 401k with a company match, paid time off, medical, dental, vision, flex spending for both health and day care, life insurance, disability, tuition reimbursement and student loan repayment, employee discount program, employee stock purchase program.
We are an equal opportunity employer and we value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.