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Trainer/ QA Auditor, PIM/Credentialing in Orange at Prospect Medical Systems

Date Posted: 11/8/2018

Job Snapshot

Job Description



Trainer/ QA Auditor, PIM/Credentialing

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

This position is responsible for quality assurance and training to ensure both new and existing employees are trained in a consistent, effective manner and that skills are continuously enhanced by ongoing education and training, answering questions regarding change forms, PIDs, roster validation and Credentialing.



Job Responsibilities/Duties

  • Responsible for training all new employees for the first 30 days of employment.
  • Responsible for creating and implementing training material for the Provider Information Management and Credentialing department to all employees are trained in a consistent manner for PIM and Credentialing, to include but not limited to Morrisey, CDA, and Sanator.
  • Audit new employees work prior to completion within 30 days.
  • Review Change Forms on CDA, Morrisey reports, emails submitted to health plans.
  • Review PID retrieval and resubmission process.
  • Review of rosters submitted to health plans.
  • Educates and updates the PIM/Credentialing Department on new guidelines.
  • Resource for training, education and coordination of improvements and additions. Attend weekly
  • meetings.
  • Weekly review of reports to identify areas for training.
  • Identify trends and report to management.
  • Special assigned projects, systems testing as needed.


Qualifications

Minimum Education: High School Diploma.

Minimum Experience: Previous experience in auditing. 

Req. Certification/Licensure: None.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance


How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm



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