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Verification Examiner

San Diego, CA

Order: 67809

We are currently looking for a Verification Examiner to work for a fast growing healthcare company in Sorrento Valley area. In this role you will complete verification of practitioner credentials according to department standards, accreditation standards, regulatory requirements, and health plan expectations. If you have previous administrative experience, then we are looking for you to join the team.


Essential Functions
• Completes 20 or more primary source verification's (PSV) daily.
• Production sheet is shared with supervisor daily.
• 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 utilizing
internal systems.
• 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.
• Provides teamwork and assistance to all department staff, including participating in special
projects and related credentialing assignments.
• Maintains an accuracy rate of no less than 99%

Requirements

  • High school diploma required.

  • 6 months data entry experience with 10 key and word processing; minimum 10,000 key strokes per hour required.

  • Experience processing medical claims and knowledge of medical billing terminology and coding strongly preferred.

 

Suna provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.