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Verification Examiner (Remote, $15/hour)
<p><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">American Specialty Health Incorporated (ASH) is seeking an Verification Examiner I to join our Credentialing department.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">The primary function of this position is to complete verification of practitioner credentials according to department standards, accreditation standards, regulatory requirements, and health plan expectations.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Remote Worker Guidelines</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Remote Worker Guidelines: This position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network. The internet connection must have a consistent 50 down/10 up Mbps minimum internet speed. 100 down/20 up is recommended to support higher quality video meetings.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Responsibilities</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Performs verification and updates PROMIS according to standards and health plan expectations.</span><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Completes 20 or more primary source verifications (PSV) daily.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Production sheet is shared with supervisor daily.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Verifies with the appropriate agencies that the applicant has a current and valid license.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Checks with the appropriate agencies to determine whether the applicant has had any sanctions against his/her license.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Determines whether the applicant has had any Medicare or Medicaid sanctions utilizing ZEBU EpStaff and sanctions from the 54 governing bodies including NPI and SSDMF.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Obtains verification of current Professional Liability Insurance and malpractice claim history for each applicant.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Verifies education through State licensing agencies or appropriate schools, colleges, or universities.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Communicates with practitioners by mail, fax, or phone to answer questions and obtain information.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Verifies whether an applicant has full or limited/partial clinical privileges by contacting the facility.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Maintains confidentiality of all practitioner data, and related issues.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Completes assigned work within predetermined timelines.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Enters data in PROMIS to complete each portion of the credentialing process within predetermined timelines.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Provides teamwork and assistance to all department staff, including participating in special projects and related credentialing assignments.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Maintains an accuracy rate of no less than 99%.</span></li></ul></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Performs other duties as assigned.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Complies with all policies and standards.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Qualifications</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">High School Diploma or GED certificate required.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">1 year computer experience including word processing and spreadsheet applications required.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Industry experience preferred.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Data Entry experience preferred.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Proficient in MS Office.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Excellent verbal communication skills with the ability to provide excellent customer service over the telephone.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Core Competencies</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Ability to effectively organize, prioritize, multi-task and manage time.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Demonstrated accuracy and productivity in a changing environment with constant interruptions.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Ability to exercise strict confidentiality in all matters.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Mobility</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Primarily sedentary, able to sit for long periods of time.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Physical Requirements</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Ability to see, speak, and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within and around the facility or Work from Home (WFH) environment. Capable of using a telephone, computer keyboard, and mouse. Ability to lift up to 10 lbs.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Environmental Conditions</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Work-from-home (WFH) environment.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>American Specialty Health is an Equal Opportunity/Affirmative Action Employer.</strong></span></p><p><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth, related medical conditions, breastfeeding, and reproductive health decision-making), gender, gender identity, gender expression, race, color, religion (including religious dress and grooming practices), creed, national origin, citizenship, ancestry, physical or mental disability, legally-protected medical condition, marital status, age, sexual orientation, genetic information, military or veteran status, political affiliation, or any other basis protected by applicable local, federal or state law.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Please view Equal Employment Opportunity Posters provided by OFCCP <u><a href="http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm">here</a></u>.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.</span></p><p><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">#LI-Remote #Verification #Claims #PROMIS #Healthcare #Review #Dataentry #Admin</span></p>