Credentialing Verifier in Orange Park, FL at Parallon

Date Posted: 3/15/2018

Job Snapshot

  • Employee Type:
  • Location:
    335 Crossing Boulevard
    Orange Park, FL
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:

Job Description

The Credentialing Verifier position will be responsible for credentialing collection and verification activities as it relates to initial credentialing, re-credentialing, and dynamic credentialing.  Tracking of issues associated with activities necessary to maintain and document ongoing compliance with CPC policy and procedures.  As requested, will be expected to research and resolve complex situations and assist with other tasks/projects.

• Receive requests for applications

• Compile application and send to practitioner

• Responsible for intake and tracking of all applications and correspondence and maintaining documentation as requested

• Assist in the credentialing process by data entry of  information into credentialing system for initial, updated, add on applications and maintenance processes

• Accurately perform a variety of administrative duties such as: placing calls, processing incoming mail, processing facsimile verifications, scanning, sending written inquires, filing, copying, and other duties as needed

• Review for completeness of information, identify deficiencies

• Pursue incomplete information

• Process and maintain credentialing and recredentialing in accordance with CPC policy and procedure, Joint Commission standards, State and Federal Regulatory regulations

 This will include but not limited to the following verifications:

 National Practitioner Data Bank  OIG/GSA for Medicare/Medicaid exemption

 DEA Verification  Licensure

 Board Certification 

• Compliance with HCA policy and procedure, Federal and State regulatory and accrediting agencies as required• 

Job Requirements


• Organization – proactively prioritizes needs.  Ability to show attention to detail.

• Communication – communicates clearly and concisely.  Must have excellent interpersonal and written communication skills.  This includes spelling and grammar skills and basic mathematical calculations.

• Customer – establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.

• Policies & Procedures – articulates knowledge and understanding of organizational policies, procedures, and systems.

• PC Skills – demonstrates proficiency in Microsoft Office (Outlook, Excel, Access, Word) applications and others as required.

• Ability to maintain confidentiality of privileged information gained.

• Ability to work independently and under pressure.

• Credentialing & Privileging technical skills –credentialing process and primary source verification knowledge.


• High School Graduate or GED. Associate degree or an equivalent combination of education and experience preferred.


• At least 1 year previous office experience including data entry, typing, and basic computer usage and proficient keyboard and PC skills preferred.

• Previous Credentialing experience preferred.  Must have basic knowledge of the Credentialing process and standards.

• Typing speed 50 words per minute.

• Completion of post Cactus training testing of 90% or greater.

• Understanding of professional telephone etiquette.

• Able to work with minimal supervision and works well in both individual and group environment.