Landmark Health

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Credentialing Specialist

Credentialing Specialist

Job Locations 
US-WA-Seattle
Category 
Operations
Type 
Temporary Full-Time
Posted Date 
11/7/2017
Job ID 
2017-1603

More information about this job

Overview

Do you want to make a difference in healthcare?

Landmark Health was created to transform how healthcare is delivered to the most medically vulnerable members in our community.  Our medical group provides home-based medical care to chronically ill patients, many of whom are frail, elderly and ill-equipped to navigate our overwhelming healthcare system.

Because many of our patients are frail and elderly, we deliver care primarily in the comfort of their home. Our Program is also offered to eligible patients at no incremental financial cost to them. We are not a fee-for-service practice; we benefit economically only if we deliver high-quality patient outcomes and satisfaction. As a result, our clinical teams can spend quality-time caring for a smaller number of patients, giving all patients the space, respect, compassion and care they deserve.

Our model is finding success throughout the country; we are now the nation’s largest risk-based, in-home medical group, with operations in six markets and four states across the country.

At Landmark, our interdisciplinary teams collaboratively manage our complex patient panels. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers, Pharmacists, Behavioral Health and other employed team members.

 

The Credentialing Specialist is a critical member of the Credentialing team, assisting in the licensing and credentialing of all Landmark Providers.   The successful candidate should be detail oriented, with excellent communication skills and experience working in health plan credentialing.

Responsibilities

  • Own the end-to-end credentialing process for Landmark providers, helping meet and improve turn-around timelines for provider credentialing
  • Renew expiring documents and certification on behalf of and in cooperation with clinical staff
  • Facilitate payment for application and renewal fees according to Accounting guidelines
  • Obtain primary source verification when indicated
  • Communicate with care providers about impending expirations and requirements for renewal
  • Coordinate with Human Resources and Accounting to obtain and verify credentialing documents
  • Maintain credentialing database and CAQH profiles with attention to detail. Data entry required
  • Observe Landmark Health policies and procedures, client contract requirements, state guidelines, and NCQA standards when credentialing providers
  • Responsible for all credentialing file additions, changes, and deletions between renewals, including but not limited to address changes and personal information updates
  • Facilitate malpractice insurance applications and certificate updates
  • Other administrative duties as determined

Qualifications

  • High school graduate or equivalent
  • Previous health plan and / or facility credentialing strongly preferred
  • Windows-based computer skills

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