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Credentialing Clerk

Monroeville, PA

At this time, we are in search of a full time Credentialing Clerk to join the team in our Monroeville office. The Credentialing Clerk is responsible for assisting in the credentialing process for new providers in health plans and the re credentialing of exiting providers by collecting and processing significant amounts of verification and accreditation information. The position is responsible for following all compliance, Medicare and HIPAA policies.

Essential Functions

  • Process initial applications and re credentialing applications for new and current providers.
  • Follow-up on application status as needed.
  • Coordinate with other departments and vendors to collect and verify credentialing information.
  • Set-up, maintain, and update both paper and electronic files and databases for providers and facilities.
  • Maintain credentialing log with insurance and provider information.
  • Maintain current corporate provider contract files.
  • Set up new facilities with insurances and find what insurances are available in the area.
  • Maintain knowledge of current health plan and agency requirements for credentialing providers.
  • Gather and maintain current copies of state licensures for all providers.
  • Track state licensures expiration dates.
  • Complete all other tasks and duties as assigned.

Qualifications and Skills

  • High School Diploma or equivalent; post-secondary education a plus.
  • Experience in a healthcare environment preferred with knowledge and understanding of the credentialing process.
  • Proficiency with Microsoft Office tools with a sharp technical aptitude.
  • Ability to communicate effectively and professionally with a wide variety of people.
  • Strong organizational skills with attention to detail and accuracy.
  • Ability to handle multiple tasks in a very busy environment.
  • Demonstrates continued interest in self and professional development.

PHOENIX offers a competitive salary and benefit package that includes PTO, and optional participation in health, dental, vision, life and disability insurances, and a 401(k) plan.

PHOENIX is an E-Verify and Equal Opportunity Employer.

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