Credentialing Specialist

Work set-up: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Minimum of 2 years of credentialing experience., High school diploma or GED preferred., Effective communication skills with healthcare professionals and agencies., Knowledge of insurance billing and hospital credentialing is a plus..

Key responsibilities:

  • Review and complete hospital and payor applications for healthcare providers.
  • Maintain and update insurance and practitioner credentialing files.
  • Track physician licensure, certifications, and CME credits.
  • Assist the Credentialing Supervisor as needed.

Healthcare Outcomes Performance Co. (HOPCo) logo
Healthcare Outcomes Performance Co. (HOPCo) Large https://hopco.com/
1001 - 5000 Employees
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Job description

Remote position!!

Benefits:

  • Competitive Health & Welfare Benefits
  • HSA with qualifying HDHP plans with company match
  • 401k plan after 6 months of service with company match (Part-time employees included)
  • Employee Assistance Program that is available 24/7 to provide support
  • Employee Appreciation Days
  • Employee Wellness Events

Minimum Qualifications:

  • Minimum of 2 years of credentialing experience.
  • High school diploma/GED or equivalent working knowledge preferred.
  • Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors, and the public
  • Must be capable of establishing good working relationships with both internal and external customers.
  • Some knowledge of insurance billing and hospital credentialing is a plus.

Essential Functions

  • Reviews and completes hospital and payor applications for all health care providers.
  • Completes verification forms/letters for outside facilities.
  • Maintain billing insurance grid, provider insurance grid, and each physician’s spreadsheet up to date on current insurance changes.
  • Track and maintain physician licensure(s), certification, and CME credits.
  • Maintain practitioner credentialing files.
  • Maintain practitioner electronic file by keeping all applications/licensure current.
  • Maintains all renewal applications for both hospitals/insurances.
  • Has knowledge of Employee Handbook content along with established policies and procedures. 
  • Relies on instructions and pre-established guidelines to perform the functions of the job.
  • Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Relationship Building
  • Communication

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