Credential Specialist - REMOTE WORK

Decypher is a leading integrator of professional, technology, and management solutions and services. We provide our services globally to Federal, Commercial, Local and State clients. Our employees are our most valuable asset and play an integral role in the success of Decypher and our clients. Working at Decypher is not a job, but a career where your talent and energy is respected, and you can personally make a difference. Decypher invites you to join our professional team.

DESCRIPTION

Decypher is seeking a Credentialing Specialist to support Fort Sam Houston, in San Antonio, TX.

RESPONSIBILITIES

• Performs credentialing tasks in support of the processes managed by the senior credentialing specialists and in response to MTFs requests.
• Designated DHA and AFMS agent to gather credentialing information, perform PSV of healthcare professionals' credentials, affiliation and work history verifications, sanction checks, and conduct databank queries. This supports the credentialing and privileging processes at DHA MTFs and ARC medical units.
• Completes written PSV documentation capturing the required components to document the PSV IAW DHA PM 6025.13, vol 4, directed by the COR and all regulatory guidelines.
• Reviews credentialing applications, conduct follow-up in a timely manner to obtain missing credentials/information, conduct verifications, create provider credentialing records within CCQAS and maintain the CCQAS record. Records must be current at all times.
• Contacts medical office staff, educational institutions, employers, licensing and certifying agencies, to obtain and complete the verification of credentials.
• Obtains required credentials and complete PSV of the credentials from the originating source or designated agent, date stamps the documentation upon receipt.
• Updates the appropriate screens within CCQAS to capture the credential and PSV of the credential. Converts documentation to a PDF format, scans, appropriately names and uploads the documentation to the provider's electronic credentials file.
• Completes credentialing tasks routed to the DHACCVO for action and appropriately updates the provider's electronic credentials file IAW DHA PM 6025.13, vol 4, and regulatory guidelines.
• Identifies and reports potential "red flags" to the requestor and submits required credentials verification summaries, completes verification tasks within CCQAS and scans, appropriately names and uploads required documentation to CCQAS.
• Audits provider credentials application and credentials file for compliance with requirements outlined in DHA PM 6025.13, vol 4, DAFI 44-119 and regulatory guidelines.
• Transfers provider credentials files to MTF credentials office or training office as appropriate. Closes out and inactivates electronic JCCQAS records when appropriate.
• Responds to queries/request for information and resolves originating request or routes the request to the appropriate individual for resolution.
• Perform National Practitioner Data Bank (NPDB) query for Registered Nurses (RNs), Licensed Vocational Nurses (LVNs), and Licensed Practical Nurses (LPNs) and any non-privileged provider as directed by the COR.
• Communicates clearly, both orally and in writing in English.
• Coordinate with the management levels, as required by DoD policies or procedures.
• Answer phone and email inquiries and direct requestor appropriately for resolution.
• Knowledge of government regulations, policies, procedures, and limitations within their scope of responsibilities.
• Knowledge of standard software programs such as the Microsoft Office Professional Suite.

This job description is not intended to be all inclusive. Therefore, the employee may be requested to perform other reasonable duties as assigned by the immediate supervisor or other management as required.

QUALIFICATIONS

• Three (3) years of experience in medical credentialing to include one (1) year of knowledge of the credentialing and privileging process, the required credentials for health care professionals, and the appropriate sources used to complete PSV, work history verifications, sanction checks, and databank queries.
• One (1) year of credentialing experience with the DoD utilizing CCQAS.
• US Citizen
• NACI background check

Rate: $55,000 Year

At Decypher we believe that equal opportunity fuels innovation by using the strengths of individual differences. Therefore, we strive to provide a welcoming and inclusive work environment. Decypher is fully committed to a program of equal opportunity for all applicants and employees and will actively carry out all federal and state regulations and executive orders. We apply our equal opportunity policy to all employment decisions.