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Under general supervision, and according to established policies and procedures, is responsible for providing personal secretarial, clerical and administrative support services to the Director of Professional Services, Manager, Professional Services, and the Supervisor of Managed Care for activity related to Health Partners Network (HPN), and WV United Insurance Services (WVUIS) (which includes WVUHS, UHA, UHP and WVUPC)

Responsibilities may include, but are not limited to providing credentialing support, preparing correspondence in final form, writing letters and memos in final form, mailing, tracking, and follow-up of participation and contract documents, and provider credentialing correspondence. Responsible for receiving and directing visitors, arranging meetings, and maintaining departmental records and files. The successful candidate will have an understanding and knowledge of the physician hospital organization, the contract service unit, and the health system.

Minimum Qualifications:

• High School diploma or equivalent.

• One year experience in professional office.
• One year of secretarial training or experience.

Position Summary:

• Under general supervision, and according to established policies and procedures, is responsible for providing personal secretarial, clerical and administrative support services to the Director of Professional Services, Manager, Professional Services, and the Supervisor of Managed Care for activity related to Health Partners Network (HPN), and WV United Insurance Services (WVUIS) (which includes WVUHS, UHA, UHP and WVUPC)
  
  
  
  
  Responsibilities may include, but are not limited to providing credentialing support, preparing correspondence in final form, writing letters and memos in final form, mailing, tracking, and follow-up of participation and contract documents, and provider credentialing correspondence. Responsible for receiving and directing visitors, arranging meetings, and maintaining departmental records and files. The successful candidate will have an understanding and knowledge of the physician hospital organization, the contract service unit, and the health system.

Please click on the link below to open and review the detailed job description and minimum qualifications:

Credentialing Assistant

MINIMUM QUALIFICATIONS :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High School diploma or equivalent.

EXPERIENCE:

1. One year experience in professional office.

2. One year of secretarial training or experience.

PREFERRED QUALIFICATIONS :

EXPERIENCE:

1. Knowledge of NCQA and CMS regulations regarding provider credentialing is preferred.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Provides support for provider credentialing by tracking applications, keying data into the credentialing program, monitoring information requested from providers, and assisting with preparation of credentials files for review in accordance with NCQA and CMS regulations.

2. Completes a wide range of typing tasks, which include correspondence, lists, forms, tables, charts, records, statistical tables, and so forth, which are often confidential in nature.

3. Assists in the preparation of administrative reports, statements, rosters and so forth; performs data or information gathering; performs statistical computations and prepares drafts or summaries for review by superior

4. Receives and screens visitors and telephone calls, relaying messages as appropriate.

5. Responds to participation and other general inquiries concerning the activities of HPN and WVUIS corporations from providers, consultants, and other internal and external customers.

6. Reviews all pertinent participation documents on date received to identify missing information. Responsible for communicating with applicants about needed information.

7. Arranges meetings and conferences, schedules interviews and appointments, completes travel arrangements, and maintains personal calendars

8. Establishes, maintains and revises record keeping and filing systems; classifies, sorts and files correspondence, articles, records and other documents.

9. Gathers data from departmental records and prepares, completes and/or processes reports, records, billings and so forth, which require an understanding of departmental/division policies and procedures.

10. Opens, sorts and distributes mail. Logs provider correspondence related to network participation and credentialing. Utilizes knowledge of various mail options for preparation of expedited mailings and certified mail.

11. Reviews correspondence, both incoming and outgoing to ensure typographical accuracy, completion of instructions and to ensure that necessary background material is attached.

12. Regularly initiates and engages in a variety of discussions with contacts, both internal and external to HPN and WVUIS in order to obtain or relay information concerning network participation, contract activity, and credentialing activity.

13. Operates standard office machines and may be responsible for contacting service personnel to repair office equipment.

14. Assists superior with “special” projects and performs a number of administrative support duties, such as coordinating the flow of work through the department offices, overseeing projects, preparing and forwarding reports, etc., in order to relieve the superior of such duties.

15. Prepares HPN dues billings subject to approval of Director of Professional Services. Issues dues billings, posts dues payments and adjustments to ledger, handles dues questions and complaints from providers and provider representatives (referring complex cases to Executive Director), and maintains write off records for dues adjustments.

16. Reviews credentialing applications and prepares correspondence requesting additional or missing information.

17. Enters physician fee information in evaluation models.

18. Must have an understanding and good working knowledge of their superior’s area(s) of responsibility in order to maintain operational records, gather data and prepare reports and complete functions of the job.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequently experiences mental/visual fatigue from data entry, filing, etc., and from the administrative pressure of the office.

2. Must be capable of adapting to various workloads, work assignments and varying work environments.

3. Prolonged sitting

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SKILLS AND ABILITIES:

1. Ability to type 35 wpm.

Remote

Monday-Friday 8a-5p

Full-time

Scheduled Weekly Hours:

40

Shift:

Days (United States of America)

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

WVUH West Virginia University Hospitals

Cost Center:

649 SYSTEM Managed Care and Payer Relations

Address:

Bridgeport WV

Bridgeport

West Virginia