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Hawaii Pacific Health Provider Credential Specialist - Centralized Verification in Honolulu, Hawaii

Job Description

Hawai‘i Pacific Health is a nonprofit health care system formed in 2001 with the merger of three longtime Hawai‘i health systems. It is the state’s largest health care provider, committed to providing the highest quality medical care and service to the people of Hawai‘i and the Pacific Region through its four hospitals, 49 outpatient clinics and service sites, and more than 1,300 affiliated physicians. The system is anchored by its four flagship nonprofit hospitals: Kapi‘olani Medical Center for Women & Children, Pali Momi Medical Center, Straub Clinic & Hospital and Wilcox Memorial Hospital, which have led groundbreaking initiatives in women’s health, pediatric care, cardiovascular services, cancer care and bone and joint services. Hawai‘i Pacific Health ranks among the top 5 percent of hospitals nationwide in the adoption of electronic medical records, with system-wide implementation that allows its hospitals and physicians to offer integrated, coordinated care throughout the state.

The Centralized Verification department oversees the process of verifying credentials of Hawai‘i Pacific Health medical professionals to ensure that we contract the most highly qualified staff for our hospitals and clinics. Responsibilities of the department include assuring compliance with all regulatory agency requirements that govern hospital credentialing, along with the enrollment process for our employed/contracted staff with insurance companies and hospitals.

If you are detail-oriented and meticulous when it comes to information management, you could help to ensure that our administrative and verification services provide the most timely, accurate and useful service to our clients. As the Credentialing Specialist Provider, you will be responsible for the enrollment process for our employed/contracted providers with various insurance companies and hospitals, including tracking and following up on payor applications and reporting on status; assisting with Hospital Credentialing; and supporting the development and maintenance of departmental manuals to include policies and procedures. We are looking for someone with excellent organizational and information management skills and a commitment to delivering the highest quality health care to Hawai‘i’s people.

*Under the Centers for Medicare and Medicaid Services (CMS) Federal Vaccination Mandate, all heath care workers must be fully vaccinated against COVID-19 or have an approved medical or religious exemption from receiving the COVID-19 vaccination.*

Location: Hawaii Pacific Health, Honolulu, HI

Work Schedule: Day - 8 Hours

Work Type: Full Time Regular

FTE: 1.000000

Bargaining Unit: Non-Bargaining

Exempt: No

Minimum Qualifications: Associate's degree in Business or Health related field and/or equivalent combination of education, training and experience. Two (2) years of secretarial or administrative experience.

Preferred Qualifications: Health care experience. Credentialing experience.


Position Provider Credential Specialist - Centralized Verification

Category Administrative

Employment Type Employee

Location Hawaii Pacific Health, Honolulu, HI

Req ID 17576