Credentialing Specialist

Are you a self-starting, independent person who thrives in a congenial, technical based environment? If so, we encourage you to apply. We are seeking experienced credentialing specialist who seeks the flexibility of from home, with the proper support and supervision provided.

Duties:

· responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by commercial payers, Medicare and Medicaid.

· Perform all activities related to credentialing, re-credentialing, and monitoring physicians and allied health practitioners. Credentialing includes, but is not limited to, the timely processing of all paperwork and applications necessary to obtain participation on all necessary insurance plans for practitioners.

· Provide timely notifications and adding/deleting new providers, adding/deleting practice locations and any other pertinent information to be supplied to insurance plans, etc.

· Gather, collate, copy and ensure filing of relevant documents needed to maintain all provider files in a “current” status.

· Submit relevant copies of documents to insurance plans to meet requirements in keeping provider files “current.”

· Actively participate in departmental meetings, payor meetings, and with departmental process and procedure development and modifications.

· Work together with Revenue Cycle team resolving credentialing issues and keep providers' credentialing status current within health record system.

· Use technology to maximize process work efficiencies and effectiveness.

Requirements:

· 2-5 years minimum experience required, specifically in medical provider credentialing for contracted health plans

· 1-3 years minimum experience required - credentialing denials with contracted health plans.

· Knowledge and/or experience of the health plan websites, CAQH, licensing boards, NPPS (NPI), Medicare (PECOS), National Provider Data Bank.

Education:

· High school diploma or GED required.

· AA degree preferred.

Work Remotely

• Yes

Job Type: Full-time

Pay: $19.00 - $22.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• Due to insurance and tax purposes we are only able to hire in Arizona, New Mexico, Colorado, and Florida. Where are you located?

Education:

• High school or equivalent (Preferred)

Experience:

• Medical Credentialing: 2 years (Required)

Work Location: Remote

Salary : $19 - $22