Verification Examiner

American Specialty Health is seeking a Verification Examiner to complete verification of practitioner credentials according to department standards, accreditation standards, regulatory requirements, and health plan expectations.

COVID-19 Considerations:

The safety of our employees, both current and future, is ASH’s highest priority. At this time, most of our employees are working remotely due to the current COVID-19 pandemic. Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. Once ASH determines employees can return the office, candidates may be required to work in a local office. Limited visits to the office in person may be required. While onsite, social distancing and masks are required along with adherence to ASH’s Communicable Disease and Pandemic Policy.

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Responsibilities

Performs verification and updates PROMIS according to standards and health plan expectations.

Verifies with the appropriate agencies that the applicant has a current and valid license.

Checks with the appropriate agencies to determine whether the applicant has had any sanctions against his/her license.

Determines whether the applicant has had any Medicare or Medicaid sanctions using the latest Cumulative Sanctions Report released by the Department of Health and Human Services.

Obtains verification of current Professional Liability Insurance and malpractice claim history for each applicant.

Verifies education through State licensing agencies or appropriate schools, colleges, or universities.

Communicates with practitioners by mail, fax, or phone to answer questions and obtain information.

Verifies whether an applicant has full or limited/partial clinical privileges by contacting the facility.

Maintains confidentiality of all practitioner data, and related issues.

Completes assigned work within predetermined timelines.

Enters data in PROMIS to complete each portion of the credentialing process within predetermined timelines.

Provides teamwork and assistance to all department staff, including participating in special projects and related credentialing assignments.

Qualifications

High School diploma required.

Industry experience preferred.

One year computer experience including word processing and spreadsheet applications.

Proficient in MS Office.

Core Competencies

Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.

Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.

Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.

Ability to effectively organize, prioritize, multi-task and manage time.

Demonstrated accuracy and productivity in a changing environment with constant interruptions.

Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.

Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Usual office setting.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.

Please view Equal Employment Opportunity Posters provided by OFCCP here.

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.

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.