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"This facility is an equal opportunity employer, and provider"
Click Here for an Application For Employment. Please include a resume.


CONTRACTING AND CREDENTIALING SPECIALIST

 

Job Summary:

 

Credentialing/re-credentialing of new and existing providers.  Maintains contract files for payers.  Renewing and maintaining state medical licenses, DEA and controlled substance registrations.

 

Essential Responsibilities:

  • Creates and maintains contract files for payers in and out of state
  • Provides current contract information to personnel as needed
  • Maintain professional relationship with provider representatives
  • Review and analyze practitioner applications and accompanying documents, ensuring applicant eligibility
  • Monitor the initial, reappointment and expiration process for Professional Medical Staff, Allied Health Professional Staff, Physical and Occupational Therapists, and additional staff as needed
  • Identify issues that require additional investigation and evaluation and ensure appropriate follow up.
  • Maintain, update and renew liability insurance for providers
  • Maintain and renew state medical licenses, DEA and controlled substance registrations
  • Maintain CAQH database, optimizing efficiency, perform query, report and document generation
  • Submit, maintain and update applications, reappointments, revalidations for providers as required by payers
  • Maintain payer information for providers.  Respond to inquiries from healthcare organizations, communicating with internal and external customers on day-to-day credentialing and privileging issues as they arise
  • Update and maintain continuing medical education (CME) data for providers
  • Submit applications and renewals with fees to applicable boards, affiliations and professional organizations
  • Maintain and provide malpractice claims reports
  • Monitor provider directories to ensure providers are correctly listed
  • Maintain CVs (curriculum vitae) for the providers
  • Answer correspondence from hospitals, managed care personnel and agencies regarding providers’ professional information.
  • Regular and reliable attendance
  • Perform other duties as assigned

 

Knowledge and Skills:

  • To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily.  The requirements listed below are representative of the knowledge, skills and/or abilities required.
  • Ability to read, analyze, interpret and prioritize daily tasks
  • Ability to write reports, business correspondence
  • Knowledge of medical contracts, credentialing, privileging procedures and standards
  • Ability to perform independently, to manage and impart confidential information
  • Ability to make administrative/procedure decisions and judgments

 

Education and Experience:

 

Associates degree or equivalent form two year college or technical school or six years related experience and/or training or equivalent combination of education and experience.

Mathematical Skills:

Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, decimals and percentages

Language Skills:

Ability to understand, read, write and speak English.  Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or governmental regulations.  Ability to successfully write reports, business correspondence and policy.  Ability to effectively present information, respond to questions and professionally interact with managers, employees, clients, vendors and the general public.

Reasoning Ability:

Ability to recognize and define problems, collect data, establish facts, draw valid conclusions and correct errors.  Ability to understand and interpret basic financial data.  Ability to interpret a variety of instructions in a variety of forms and deal with abstract and concrete variables.

Other Qualifications:

Posted:   2/28/14

 

Exhibit a comprehensive understanding of healthcare regulatory and compliance policy (e.g., HIPPA.)  Knowledge of the facility policies and procedures; knowledge of payer contracts and amendments, medical staff bylaws, business office standards and recommended practices.  Requires ability to identify and implement opportunities to improve performance of the center(s).  Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous good judgment and positively influence and lead others, including handling confrontations with poise and efficiency.  Establishment of professional relationships with payer provider representatives, maintaining these contacts and attending meetings to discuss issues.  Advanced computer skills (including, but not limited to spreadsheets, word documents, internet and email) required.  Ability to work a flexible schedule, including some evenings and weekends.

Operating Room Tech

 

Job Duties:

  • Organizes equipment in the operating room
  • Sets up the sterile table for the surgeon
  • Prepares dressings
  • Prepares patients for surgery
  • Checks all equipment before surgery
  • Helps surgeons and his assistants to don their surgical gloves and gowns
  • Keeps an account of surgical instruments before and after surgery
  • Hands appropriate instruments to surgeons during operations
  • Cleans all surgical instruments after surgery
  • Helps in cleaning operating tables and the room after surgeries
  • Helps in transferring patients from operating room to recovery rooms
  • Gets any additional instruments an equipment as and when needed during surgeries
  • Handles lights, sterilizers and suction equipment during surgeries
  • Restocks the operating room with supplies after every surgery

Knowledge and Skills:

  • Good dexterity to handle and pass surgical instruments quickly and accurately
  • Should be methodical with good organizational skills
  • Good command over surgical procedures
  • Upgrades knowledge of all recent developments
  • Practices sterile clinical procedures all the time
  • Knowledge and maintenance of all equipment in the operating room

 

Educational Qualification and Experience:

  • High School diploma
  • AT LEAST ONE YEAR EXPERIENCE A MUST

 

Please submit an application which can be printed from www.northsunflower.com along with a resume’ to:                                                                                   

 

 

 

Human Resources                                                                                          

 

 

 

NO PHONE CALLS PLEASE
P.O. Box 369
Ruleville, MS  38771

 Click Here for an Application For Employment.  Please include a resume.