SUMMARY:
The Health Plan Credentialing Enrollment Assistant not only directly supports the Chief Human Resources Officer, but also the Credentialing coordinator the Health Plan Credentialing Enrollment Assistant supports the efforts of all members of the Camarena Health team and community by providing the necessary information relating to the health center and administrative processes. This full-time non-exempt position is responsible for the general oversight of the credentialing and administration office functions (i.e. filing, mail management, etc.).
EXPECTATIONS:
Arrives on time and adheres to set schedule.
Supports general unit operations through the completion of specific clerical and data entry support duties.
Supports the Director of Human Resources with administrative projects and assignments.
Provides support to various departments within the organization
Use of professionalism and best efforts in your position.
DUTIES and RESPONSIBILITES
1.0 Focus on Administrative Support:
1.1 Enrolling providers into various health plans
1.2 Updating health plan enrollment log
1.3 Scanning / filing enrollment forms
1.4 Health plan follow up and
1.5 Updating CAQH files
1.6 Updating NPPES provider information
1.7 Running NPDB queries
1.8 PAVE enrollment
1.9 PECOS enrollment
1.10 Collecting provider signatures
1.11 Updating optometry log
1.12 Updating dental CME tracking log
1.13 Mail distributing
1.14 Provides support to various departments within the organization as needed
2.0 Focus on Corporate Expectations/Standards:
2.1 Attends and actively participates in all meetings (e.g., team meetings, department meetings, program meetings, employee staff meetings) and other activities as required or assigned.
2.2 Works flexible or extended hours where necessary.
2.3 Demonstrates awareness of, and compliance with, organizational mission and objective of Camarena Health to provide health care access and support services for all members of the community.
2.4 Other work-related duties as assigned by supervisor; duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.
2.5 Maintains confidentiality and respect for information regarding patients and other team members; abides by Camarena Health Rules of Confidentiality
3.0 Credentialing Expectations:
3.1 HR Clerk / Credentialing not only supports the Chief Human Resources Officer by providing the necessary information relating to recruitment positions also helps with benefits and compensation, ancillary projects, and HR processes. Facilitates all aspects of Camarena Health, Health Plan Credentialing process, including initial enrollment, re-credentialing every two years for various health plans.
3.2 Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to health plan credentialing enrollments.
3.3 Responsible for the accuracy and integrity of the health plan credentialing database system and related applications. Works under the supervision of the Chief Human Resources Officer. As well as the general oversight of HR office functions (i.e., filing, updating, etc.).
3.4 It is the function of the HR unit to operate as internal customer service support for staff, assisting in department’s focus by providing clear and accurate information to both staff and the general public interested in provider information.
MINIMUM REQUIREMENTS:
Education:
High School Diploma or GED
Prior Experience:
Two to four years’ experience in progressively responsible for Provider Health Plan enrollment.
Skills:
Effective oral and written skills; general report writing skills.
Telephone courtesy; customer-service oriented.
Modern office practices and procedures including email.
Intermediate to expert user computer skills.
Highly organized.
History and proven record of effective program/project management.
Attention to detail and excellent follow-through on work tasks.
Demonstrates good problem-solving skills.
Able to track multiple tasks and complete promptly.
Able to quickly build and maintain rapport with employees and providers of differing backgrounds; team player.
Physical Requirements:
Must be able to move up to 20 pounds and push up to 50 pounds (on wheels).
Must be able to hear staff on the phone and those who are served in-person, and speak clearly in order to communicate information to clients and staff.
Must be able to have vision that is adequate to read memos, a computer screen, personnel forms and clinical and administrative documents.
Must have high manual dexterity.
Must be able to reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouching, reaching, kneeling, twisting/turning, fingering and feeling.
