Credentialing Specialist

Overview:

This position operates on an Eastern time zone schedule.

Position Summary
Responsible for performing all tasks related to the credentialing, filing, updates and follow-up for CPa Medical Billing.

Job Type: Full-time

Pay: $19.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Schedule:

• Monday to Friday

Work Location: Remote

ESSENTIAL FUNCTIONS & RESPONSBILITIES

• Complete credentialing and/or re-credentialing applications for physicians and ancillary providers with third-party payers and governmental programs (Medicare and Medicaid) as requested by the client in an accurate and timely manner
• Complete, update and maintain Council for Affordable Quality Healthcare (CAQH) profiles for providers
• Ensure credentialing data needed for enrollment, contracting, and other related purposes is on file.
• Maintain provider credentialing files electronically
• Maintain credentialing software with current information
• Reach out to insurance carriers regarding any outstanding items/applications
• Resolve issues related to provider participation
• Respond to various inquiries from participating physicians, staff, hospitals, and managed care companies timely and with professionalism
• Maintain a strict level of confidentiality for all matters pertaining to provider credentials
• Communicate client/enrollment issues to management at an early stage
• Must be able to work on various projects as assigned by Credentialing Manager
• Other duties as assigned

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• Other duties as assigned

JOB QUALIFICATIONS/REQUIREMENTS
EDUCATION: High school diploma or GED equivalent
EXPERIENCE: Three to Five years of relevant healthcare experience is required including specialized skills in Credentialing. Experience with Windows applications, proficient use of computer, Microsoft Word, Outlook and Microsoft Excel. Strong communication, verbal and written and interpersonal skills. Ability to analyze and solve problems with limited assistance.
LANGUAGE SKILLS: Knowledge and use of the English language, Bi-lingual a Plus
MATHEMATICAL SKILLS: Basic math skills
REASONING ABILITY: Critical thinking, analytical and problem-solving skills
A successful candidate will have the following:

• Outstanding customer service, interpersonal and written skills.
• The ability to work independently, as well as, in a team setting
• Exceptional organization and time management skills to manage priorities and deadlines
• Strong attention to detail and quality
• Proficiency with Microsoft Office suite (Word, Outlook); Excel preferred