GENERAL DUTIES AND RESPONSIBILITIES

The HR Assistant and Credentialing Specialist's primary duties include maintaining information in Credentialing File in HQ Shares for each provider, assisting with new provider orientation to the credentialing and privileging process at RHCC, and other insurance credentialing duties and assisting with HR duties.

SPECIFIC DUTIES AND RESPONSIBILITIES:

1. Assist in maintaining files on all RHCC Programs that include up to date center billing numbers, insurance contracts, effective rates, etc.

2. Assist in maintaining files on RHCC Providers and ensures that all have/are enrolled with appropriate third-party payers and have provider billing numbers to assure proper and timely processing of claims.

3. Assist in maintaining master files on all RHCC locations and ensures that all sites are enrolled with the appropriate payers and demographic information is updated as needed.

4. Update information in Credentialing File in HQ Shares for each provider and facility.

5. Staff will assist with data entry and/or submission for the following:

a. Ensure new providers have the following information completed and submitted:

i. Uniform Application

ii. DEA Cert

iii. Licenses

iv. Curriculum Vitae/Resume’

v. Private Insurance Attestation

vi. Passwords for CAQH, NPPES and NCTracks

b. Assist with Creating or Updating Password file for each CHC and PCS Clinicians

c. Complete data entry for applications in NCTracks for new CHC and PCS Clinicians

i. Ensure facilities data are entered and linked.

ii. Assist with ensuring License, DEA and diplomas are uploaded.

iii. Assist with ensuring training is complete for new provider.

6. Perform data entry to update information in NCTracks for CHC providers, PCS Clinicians, and facilities.

7. Perform data entry to complete profile in CAQH for new CHC providers, PCS Clinicians, and facilities Ensure provider is linked from RHCC.

a. Ensure all licensure, certifications, liability insurance and attestation are completed and uploaded.

8. Perform data entry to update information in CAQH for current providers.

a. Verify current information for providers.

b. Every 30-90 days each provider profiles are attested.

9. Perform data entry to complete application in NPPES for providers and verify active status in NPPES for provider or facility (Medicare)

10. Assist in updating information for MCO credentialing application for PCS.

11. Perform data entry to update roster credentialing information for CMHN, WellCare, etc.,

12. Assist with contacting various payers regarding credentialing status. 13. Assist with verifying information for providers and facilities through validation@betterdoctor.com

14. Assist with verifying, updating, and submitting credentials to Aperture Credentialing, LLC, a national credentials verification organization for various private insurance.

15. Perform any other necessary duties as required by the Robeson Health Care Corporation.

16. Maintain the confidentiality of Robeson Health Care Corporation and that of the patients/clients/staff.

QUALIFICATIONS

1. Graduation from a Business or Technical School in a secretarial training program or equivalent working experience.

2. A minimum of 3-5 years' secretarial/administrative experience.

3. The ability to use current office machines including word processors.

4. The ability to effectively communicate both verbal and written.

Job Type: Part-time

Pay: From $12.00 per hour

Expected hours: 24 per week

Schedule:

• Day shift

Experience:

• Microsoft Office: 1 year (Preferred)
• Microsoft Word: 1 year (Preferred)

Work Location: In person