Waikiki Health is seeking a full-time Credentialing & Privileging Specialist. Pay rate: $20.00 – $25.00 per hour, depending on experience. Schedule: 40 hours per week, Monday through Friday Reports to the HR Manager. The Credentialing & Privileging Specialist evaluates, analyzes, and coordinates all aspects of the clinical staff licensing, verifications, partners with MedTrainer for credentialing and privileging and assists with HRSA-related projects. Provides integral support to healthcare operations by enabling timely onboarding of healthcare providers. Duties include but are not limited to : Works as a liaison between Waikiki Health and MedTrainer for all aspects of credentialing and privileging while following federal, and state regulations, guidelines, Waikiki Health policies, and standards. Conducts primary source verification, collects, and validates documents to ensure accuracy of all credentialing and privileging elements; assesses completeness of information and qualifications relative to Waikiki Health credentialing criteria. Enters updates and maintains data from provider credentialing and privileging application. Complete HRSA-related documentation and information from Human Resources. Communicates clearly with providers, their liaisons, internal partners of revenue cycle, human resources, and medical staff leadership and external partners, as needed to provide timely responses upon request on day-to-day issues as they arise. Verify patient insurance coverage and benefits, ensuring accurate billing and adherence to payer requirements. Other duties as assigned. Qualifications and abilities : High school diploma required. Bachelor’s/associate degree preferred, or a minimum of 2 years of experience in program coordination, program management or health care systems. Experience in project management, database management, electronic medical record, and provider relations preferred. Familiarity with working with all types of insurance carriers, including Medicare and Medicaid (Med-QUEST) preferred. Waikiki Health requires proof of the following immunization, with or without reasonable accommodation: TB skin test or chest X-ray, and Hepatitis B (optional). #J-18808-Ljbffr Waikikihealth
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