Role overview

Qualifications

Experience with provider enrollment
Knowledge of managed care companies and insurance carriers
Familiarity with federal and state regulations
Strong organizational skills

Responsibilities

Create and maintain licensing, credentials and insurance records
Conduct research on updated state and federal regulations and policies
Help develop internal credentialing processes
Monitor license and credential expiration dates and advise staff members of required 'renew by' dates

Key facts

Remote from: North Carolina (USA)
Full time
Conference Coordinator
English

Hard skills

Enrollment Management Regulatory Compliance Database Management Health Insurance Portability And Accountability Act (HIPAA) Compliance

Other skills

Research
Communication
Organizational Skills
Detail Oriented

About the company

Allergy Partners

Allergy Partners is the nation’s largest single-specialty practice in allergy, asthma and immunology. Our network of over 130 providers spans over twenty three states and encompasses over 130 total locations of service. Allergy Partners specializes in the diagnosis and treatment of asthma, allergic disease, food allergies, drug allergies, recurrent infections, repeated sinusitis, COPD, eczema, bee testing, immune deficiencies, and more. Allergy Partners physicians are trained in the diagnosis, treatment, and management of asthma and allergic diseases. We will obtain a detailed history, perform a physical exam, and determine the best personalized and comprehensive treatment plan for our patients. As the leaders in allergy and asthma care, our physicians provide patients with the highest quality, evidence based, and cost effective allergy and asthma care possible.

Company details

Company size1001 - 5000

Links

LinkedIn See all jobs

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Responsible for provider enrollment with payors to include: perform credentialing and re-credentialing related functions for all Allergy Partners providers on a national and state level with managed care companies, payors, and/or insurance carriers for new physicians and start-up practices. Serves as a resource and liaison to implement and resolve issues related to credentialing.

Responsibilities include, but are not limited to, the following:

Create and maintain licensing, credentials and insurance records
Conduct research on updated state and federal regulations and policies
Help develop internal credentialing processes
Monitor license and credential expiration dates and advise staff members of required “renew by” dates
Ensure the Providers and staff members are maintaining compliance with regulatory and accrediting institutions
Maintain tracking database for all credentialing activities
Completes provider credentialing and re-credentialing applications, nationwide; monitors applications and follow-up as needed
Maintain and monitor current state licenses, DEA licenses, malpractice insurance and any other required credentialing documents for all providers
Continual maintenance of provider files
Processes applications for credentialing and re-credentialing
Other Duties as assigned

OTHER

Completes all assigned AP training (such as CPR, OSHA, HIPAA, Compliance, Information Security, others) within designated timeframes.
Complies with Allergy Partners and respective hub/department policies and reports incidents of policy violations to a Supervisor/Manager/Director, Department of Compliance & Privacy or via the AP EthicsPoint hotline.

Typical Physical Demands Physical demands are moderate with occasional lifting of items weighing approximately 20 – 30 pounds; vision must be correctable to normal range and hearing acuity must be adequate to receive instructions and converse on standard telephone equipment; must have manual dexterity sufficient to operate a keyboard and other standard office equipment. Typical Working Conditions Normal office environment. Occasional evening or weekend work.