Offer summary

Qualifications:

High school diploma or equivalent experience required., Prior experience in Medical Credentialing Process and Revenue cycle is essential., Strong attention to detail and effective communication skills are necessary., Proficiency in Microsoft Office applications and ability to manage multiple priorities is important..

Key responsibilities:

Maintain accurate data entry and revise practitioner data in the credentialing database.

Complete provider credentialing and re-credentialing applications and monitor their progress.

Collaborate with HR for onboarding practitioners and communicate with field staff during the credentialing process.

Ensure compliance with Federal & State regulations regarding credentialing and licensing.

Job description

Upstream Rehabilitation, is looking for a Provider Credentialing Specialist to join our team

JOB SUMMARY:

The Provider Enrollment Credentialing Specialist is responsible for all aspects of the credentialing & re-credentialing all medical providers & groups who provide patient care to individual partner groups that fall under Benchmark Rehab Partners LLC. Ensure providers are credentialed, appointed, and privileged with contracted health plans. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications

JOB RESPONSIBILITIES:

Maintain timely and accurate data entry and periodically revise practitioner data in the credentialing database OneApp.
Maintain practitioner paper and electronic data files for practitioners
Use the CAQH system to submit practitioner data as required by some client health plans to credential individual practitioners.
Initial setup and/or maintenance of approved participating online payer systems.
Completes provider credentialing and re-credentialing applications.
Monitors applications and follows-up as needed to ensure enrollment with contracted health plans.
Maintains copies of current state licenses and any other required credentialing documents for all assigned providers.
Collaborate with HR to facilitate onboarding for all practitioners.
Communicate with field & therapist during the credentialing process and respond to field inquires in relation to credentialing request.
Communicate with payers for necessary updates and processes.
Uphold Federal & State regulations in regards to credentialing & licensing of clinicians’ agencies.
This position may cross-train to perform tasks from other positions.

JOB QUALIFICATIONS:

High school diploma or equivalent experience.
Prior experience in Medical Credentialing Process and Revenue cycle.
Attention to detail, self-motivated and the ability to communicate effectively.
Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
Proficient use of Microsoft Office applications (Word, Excel, Adobe) and internet resources.
Ability to organize and prioritize work and manage multiple priorities and deadlins.

Fulltime positions include:

Annual paid Charity Day to give back to a cause meaningful to you
Medical, Dental, Vision, Life, Short-Term and Long-Term Disability Insurance
3-week Paid Time Off plus paid holidays
401K + company match

Follow @Lifeatupstream on Instagram, and check out our LinkedIn company page to learn more about what it’s like to be part of the #upstreamfamily.

CLICK HERE TO LEARN EVEN MORE ABOUT UPSTREAM

Upstream Rehabilitation is an Equal Opportunity Employer that strives to provide an inclusive work environment where our differences are celebrated for the value they bring to our communities, our patients and our teammates. Upstream Rehabilitation does not discriminate on the basis of race, color, national origin, religion, gender (including pregnancy), sexual orientation, age, disability, veteran status, or other status protected under applicable law.

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