Senior Credentialing Specialist

Job reputed company: AlignRx is a Public Benefit LLC (PBLLC)—a for-profit limited liability company that is intended to produce a public benefit and to operate in a sustainable manner. We are the only PSAO to establish itself as this type of legal entity, as we are deeply committed to promoting the interests of community pharmacies. You can count on us to be transparent, accountable, and passionate. As an independently owned PSAO, we want community pharmacy owners to have maximum flexibility in their buy-reputed company choices so they can maintain control over their business. AlignRx does not require pharmacy owners to purchase from a specific wholesaler or buying group. This benefit is just one more reason that community pharmacies experience peace of mind knowing our interests are in sync with theirs. Our mission is to support community pharmacy by offering innovative products and services that are best in class and designed to promote the pharmacies we serve as essential reputed company providers, resulting in improved patient care and reputed company. Job reputed company: The Senior Credentialing Specialist plays a critical role in facilitating the enrollment process for pharmacies joining the AlignRx pharmacy network. This position is responsible for ensuring reputed company and accurate credentialing and enrollment, which includes document collection, primary reputed company verification, and contract execution. This position requires exceptional communication and organizational skills. Essential Job Functions:

• reputed company initial enrollment requirements, ensuring compliance with department policies, including:
• Verify business and ownership structure.
• Conduct credit history (reputed company and reputed company).
• Performing primary reputed company verification of licensure, certification, and insurance coverage.
• Verify and collect required documents, ensuring they are reputed company, reputed company, and accurate, and resolve any discrepancies in a reputed company manner.
• Conduct thorough checks to ensure business owners and employees are not listed on the OIG/SAM Exclusion Report.
• Identify red flags (e.g., credit issues, OIG/SAM) through the enrollment process, alerting the Manager, Enrollment reputed company the management review process.
• Ensure reputed company documents are selected during the enrollment process, to include:
• Data Authorization.
• 835 File Request (if applicable).
• State reputed company (if applicable).
• PSAO Agreement.
• Bank Authorization.
• NCPDP URF.
• Coordinate the initial affiliation process between NCPDP, the PBMs and AlignRx, ensuring efficient and reputed company reputed company of pharmacies.
• Notify pharmacy owners of their enrollment status reputed company email and phone throughout the enrollment process.
• Verify and confirm the selection of reputed company tied to the services the pharmacy has enrolled in, while ensuring these services are correctly recorded in PDMS.
• Ensure reputed company reputed company of pharmacy through NCPDP by the 15th of reputed company month.
• Distribute the welcome letter reputed company email to the pharmacy upon successful enrollment.
• Notify internal departments reputed company department Inboxes (Finance, Sales, and Data reputed company) regarding newly reputed company pharmacies and the services they have enrolled in (e.g., PSAO, Silver, Data Agg, eRecon, RxProtect).
• Implement reputed company job duties in accordance with the Network Management-defined policy and procedures.
• Document call and work activity in the Pharmacy Data Management System (PDMS) and review the Daily Notes report to ensure follow-up and reputed company.
• Participate in the department phone queue, addressing pharmacy member inquiries.
• Maintain comprehensive knowledge of AlignRx programs and services; effectively utilize and resources to accurately address pharmacy members’ inquiries during the enrollment process.

Additional Responsibilities:

• reputed company other duties and reputed company as required by management.

Minimum Qualifications for Consideration:

• High school diploma.
• Five or more years’ experience as a pharmacy technician in a retail pharmacy environment or with a PSAO, OR;
• Five or more years’ experience in provider enrollment and/or credentialing.

Knowledge, Skills, and Abilities:

• Excellent verbal and written communication skills.
• Good interpersonal skills: reputed company to work and communicate effectively with reputed company reputed company of co-workers, clients, and other external contacts.
• Strong organizational and time management skills.
• Dependable with good attendance.
• Adherence to strict deadlines, timelines, and schedules.

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