Associate-Account Management
Sutherland
Davao
5d ago

Job Description

Sutherland is seeking for a Credentialing Associate. We are a group of driven and hard-working individuals. If you are looking to build a fulfilling career and are confident you have the skills and experience to help us succeed, we want to work with you!

Associates in this role get to :

Support the team : Assist with training and quality assurance of peer staff -Coach, Mentor, Grow.

Improve the company : Resolve problems and administrative issues. Fix problems. Promote success.

  • Keep things running : Keep accurate data for requested monthly URAC (Utilization Review Accreditation Committee) report;
  • Create accurate daily inventory report for manager. Report what’s important. Support ongoing growth.

    Take the lead : Lead staff in the absence of the manager. Lead on the fly, succeed naturally.

  • Keep Sutherland aligned : Receive applications, assure completeness and verify credentials; Maintain accurate initial and re-credential files, monitoring at least 20 files per week;
  • Create and maintain provider files within the database.

    Impact the bottom line : Call provider offices and U.S. licensing boards for missing information; confirm accuracy of data that has been presented.

    Qualifications

    Our most successful candidates will have :

    Full working knowledge of provider credentialing and current URAC standards

    High School Diploma or equivalent (Bachelor’s Degree preferred)

    Five or more years of experience in Healthcare Operations

    Three or more years of experience Credentialing / Re-credentialing Providers (preferred)

    Two or more years of experience working in a Healthcare setting handling high level provider related issues

    One or more years of experience in calling provider offices

    Proficient level skills with MS office suite (Word and Excel)

    Working knowledge of desk top PCs and Provider software

    Broad understanding of Health insurance programs and HIPAA regulations

    Experience in managing provider databases

    Understanding of all SLAs that are in the Clients agreement; day-to-day receipts and ageing reports from the inventories

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