Credentialing Specialist - Central Administration

Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. This is a Monday-Friday, Day position. The teammate will be responsible for Credentialing and Payer Enrollment for providers with commercial and government payers.

Summary:

Responsible for the coordination/processing of all applications for credentialing/recredentialing of practitioners to UNC Hospitals Medical Staff and Allied Health Professional Staff, in accordance with JCAHO, NCQA, and other regulatory standards. Communicates with a wide variety of internal/external customers. Inputs and maintains practitioner data in SMS (PRDOC) and ECHO credentialing systems use of these databases to generate a wide variety of listings and reports. Assists with onsite audits of credentials files by managed care organizations. Assists with day-to-day operations of the office.

Responsibilities:

1. Coordinates the administration and scheduling of a variety of professional meetings, seminars, or conferences. Coordinates the planning and logistical arrangements for special events. Maintains detailed calendars and records and confirms logistics associated with events. (O) 2. Prepares a variety of office documents, records, reports, charts and graphs. Determines some format, content and presentation. Gathers, analyzes and compiles information into report format. (O) 3. Provides leadership and guidance to co-workers. (O) 4. Responds to inquiries with written explanation by interpreting established policies and procedures. Coordinates mail screening and distribution. (O) 5. Serves as primary resource with internal and external contacts on administration of office program and/or program policies and procedures. Explains program services to recipients or the public and explains eligibility.

Other Information Other information:

Education Requirements:

• Bachelor's degree in an appropriate discipline (or equivalent combination of education, training and experience).

Licensure/Certification Requirements:

• No licensure or certification required.

Professional Experience Requirements:

• If a Bachelor's degree: No prior experience required.
• If an Associate's degree: Four (4) years of equivalent experience in related field.
• If a High School diploma or

GED:

Eight (8) years of equivalent experience in related field.

Knowledge/Skills/and Abilities Requirements:

Job Details Legal Employer:

NCHEALTH

Entity:

UNC Health Medical Group Organization Unit:

Central Administration Work Type:

Full Time Standard Hours Per Week:

40.00

Salary Range:

$20.74 - $29.52 per hour (Hiring Range) Pay offers are determined by experience and internal equity

Work Assignment Type:

Hybrid Work Schedule:

Day Job Location of Job:

US:

NC:

Morrisville Exempt From Overtime:

Exempt:

No This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position. Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation. UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.