Credentialing Specialist jobs in Merrimack, NH
Recently Added Credentialing Specialist jobs
Provider Credentialing Specialist
- DMC Primary Care
-
Windham, NH
FULL_TIME
-
DMC Primary Care, a physician-owned, independent practice, with offices throughout southern New Hampshire, has been providing comprehensive care for entire families since 1964. We help each patient achieve the best possible health through every stage of life. We do this by providing an accessible, innovative healthcare experience that is built around our patient’s needs.
We are hiring a Provider Credentialing Specialist. This is a full-time position in Windham, NH.
The Provider Credentialing Specialist is responsible for overseeing and coordinating DMC’s onboarding and credentialing process for new providers and ongoing revalidation. The credentialing specialist will acquire primary source information necessary for DMC employment, as well as both initial and reappointment application or verification with all contracted health plans to ensure that all physician and non-physician provider requirements are met.
DUTIES INCLUDE:- Maintaining a thorough understanding of federal and state regulations, payer policies, and requirements in order to ensure a compliant provider employment and credentialing process for Derry Medical Center
- Performing the credentialing and privileging process in accordance with all governmental and commercial payer credentialing applications
- Collaborating closely with the Director of Human Resources and Medical Staff Coordinator to assist with DMC’s provider onboarding process
- Tracking and following up on physicians’ initial application/onboarding process and reappointment applications by performing primary source verification, preparing agency correspondence, and tracking responses within the organization’s provider database
- Maintaining individual provider files with up to date information and completes the revalidation requests issued by all governmental and commercial payers, as well any other DMC employment requirements
- Working with necessary individuals—including physicians, Human Resources, other professional staff, and their office or clerical staff—to acquire necessary materials and information for provider certification and licensure
- Assisting in filling out and reviewing credentialing applications and other employment requirements with practitioners and other applicable staff
- Notifying applicants when further information is requested regarding their background, training, demonstrated ability, previous performance, current competence, physical and mental health status, continuing education, etc.
- Maintaining accurate provider profiles on CAQH, PECOS, CMS, and other necessary databases
- Safeguarding the integrity of privileged information, credentialing and employment files in a professional and sensitive manner
- Identifying sanctioned providers on state and federal disciplinary action reports and initiates the requisite corrective processes to address cited violations
- Querying the National Practitioner Data Bank as needed, and does so in compliance with the Healthcare Quality Improvement Act (HCQIA)
- Remaining compliant with and knowledgeable of rules and regulations set forth by the Health Information Portability and Accountability Act (HIPAA), Joint Commission standards, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid Services, as well as state regulations— and relays this information to the necessary parties to ensure ongoing compliance organization-wide
- Providing all office visitors, credentialing contacts, payer representatives, and agency intermediaries with excellent customer service
- Collaborating with the billing department to help resolve and denials or authorizations issues related to provider credentialing
- Assisting the department manager and related staff with additional administrative tasks as needed
- Continuously seeking out further information and education through appropriate resources and references approved by management to research accurate answers and guidance for role and responsibilities. This includes maintaining any necessary reference guides, policies, procedures, FAQs, etc as a resource and reaching out to management and or other appropriate individuals for guidance when research performed does not provide an appropriate resolution
- Possessing high-level organizational skills and the ability to multi-task and work under pressure, while presenting a calm, professional manner and positive attitude
EDUCATION & TRAINING:- High school diploma or equivalent required
- At least two years of experience in healthcare provider credentialing required
- Proven experience working directly with healthcare personnel, such as physicians, in an office setting required
- Experience with Microsoft Office Suite (Word, Excel, Outlook, etc)
- Training, education, or certification in practitioner credentialing preferred
- Competitive hourly salary
- Comprehensive medical/dental benefits at 32 hours
- Paid time off
- 401K
For more information, please visit www.DMCPrimaryCare.com.
We are an equal opportunity employer embracing the strength that diversity brings to the workplace. We provide a welcoming and supportive environment for employees of all ethnic backgrounds, cultures, ages, lifestyles and physical abilities.
- 1 Month Ago
Billing Specialist
- Rightworks LLC
-
Hudson, NH
FULL_TIME
- Rightworks offers the only intelligent cloud purpose-built for accounting firms and professionals. Backed by award-winning around-the-clock US-based support, our fully managed IT and applications ensu...
- 19 Days Ago
Billing Specialist
- Nashua Eye Associates
-
Nashua, NH
FULL_TIME
- Billing and Reimbursement Specialist We are Currently Hiring! Nashua Eye Associates is an Ophthalmology Practice located in Nashua New Hampshire. We are currently looking for an energetic billing and ...
- 21 Days Ago
IT Specialist
- Sequel Medical Technology
-
Manchester, NH
FULL_TIME
- About SequelSequel Med Tech is an early-stage company developing the next generation of precision drug delivery devices.Job OverviewReporting to the Sr. Director, IT and Infrastructure, the Senior IT ...
- 21 Days Ago
Marketing Specialist
- IPS Cash
-
Nashua, NH
FULL_TIME
- Are you interested in a career in marketing with upward mobility and an opportunity to learn from experts in the industry? We’re in search of a dynamic marketing coordinator to support our senior staf...
- Just Posted
Purchasing Specialist
- Reardon Associates
-
Merrimack, NH
FULL_TIME
- Merrimack, NH Reardon Associates is looking for a Purchasing Clerk to join our team. This position is responsible for the purchase of materials and supplies for the company. The ideal candidate will h...
- Just Posted
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0 Credentialing Specialist jobs found in Merrimack, NH area
TRAVEL NURSE RN - TELEMETRY - $2,843 PER WEEK IN MANCHESTER, NH
- GO Healthcare Staffing
-
Manchester, NH
- Our client in Manchester NH has a 12HR DAY (48HR) travel position for an RN with current Med/Tele experience. The ideal ...
- 4/24/2024 12:00:00 AM
TRAVEL NURSE RN - MED/SURG - $2,145 PER WEEK IN MANCHESTER, NH
- GO Healthcare Staffing
-
Manchester, NH
- Our client in Manchester NH has a 12HR NIGHT travel position for an RN with current MedSurg experience. The ideal candid...
- 4/24/2024 12:00:00 AM
TRAVEL NURSE RN - TELEMETRY - $2,843 PER WEEK IN NASHUA, NH
- GO Healthcare Staffing
-
Nashua, NH
- Our client in Nashua NH has a 12HR DAY (48HR) travel position for an RN with current Med/Tele experience. The ideal cand...
- 4/24/2024 12:00:00 AM
TRAVEL NURSE RN - MED/SURG - $2,445 PER WEEK IN GARDNER, MA
- GO Healthcare Staffing
-
Gardner, MA
- Our client in Gardner MA has a 12HR NIGHT travel position for an RN with current MedSurg experience. The ideal candidate...
- 4/24/2024 12:00:00 AM
TRAVEL NURSE RN - TELEMETRY - $2,683 PER WEEK IN CONCORD, MA
- GO Healthcare Staffing
-
Concord, MA
- Our client in Concord MA has a 8HR NIGHT travel position for an RN with current Med/Tele experience. The ideal candidate...
- 4/24/2024 12:00:00 AM
TRAVEL NURSE RN - OR IN NEW HAMPSHIRE
- Care Team Solutions
-
Manchester, NH
- Details: Must Have 2+ Years of recent Operating Room experience. Specialty: Operating Room Discipline: Registered Nurse ...
- 4/24/2024 12:00:00 AM
TRAVEL NURSE RN - STEPDOWN - $2,992 PER WEEK IN MANCHESTER, NH
- GO Healthcare Staffing
-
Manchester, NH
- Our client in Manchester NH has a 12HR NIGHTS (48HR) travel position for an RN with current Step Down experience. The id...
- 4/23/2024 12:00:00 AM
Travel Nurse RN - Med/Surg in Manchester, NH
- Care Team Solutions
-
Manchester, NH
- Details: Must Have 2 Years of recent Medical-Surgical experience. Specialty: Medical-Surgical Discipline: Registered Nur...
- 4/23/2024 12:00:00 AM
About Merrimack, New Hampshire
Merrimack is a town in Hillsborough County, New Hampshire, United States. The population was 25,494 at the 2010 census, and an estimated 25,660 in 2017, making it the ninth-largest municipality in New Hampshire.
There are four villages in the town: Merrimack Village (formerly known as Souhegan Village), Thorntons Ferry, Reeds Ferry, and South Merrimack.
According to the United States Census Bureau, the town has a total area of 33.4 square miles (87 km2), of which 32.6 sq mi (84 km2) is land and 0.8 sq mi (2.1 km2) (2.48%) is water. The highest point in Merrimack is an unnamed hill in the nor...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Credentialing Specialist jobs
$48,351 to $60,821
Merrimack, New Hampshire area prices
were up 1.4% from a year ago
were up 1.4% from a year ago
What does a Credentialing Specialist do?
Credentialing Specialist in Irving, TX
Plans and organizes work effectively and ensures its completion.
February 28, 2023
Credentialing Specialist in New Haven, CT
Posts newly approved privileges and prepares and sends personalized appointment letters to each applicant including, as appropriate in each case, reference to relevant hospital policies and procedures.
May 19, 2023
Credentialing Specialist in Oklahoma City, OK
Adhere to the First Physicians Code of Conduct and Behavior Standards.
April 02, 2023