Medical Staff Credentialing Specialist, Sr. jobs in Connecticut

Medical Staff Credentialing Specialist, Sr. processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist, Sr. sets up and maintains provider information in an online credentialing database system. Tracks license and certification expirations for all providers to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist, Sr. may require an associate degree or equivalent. May require certification as a Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor or manager. The Medical Staff Credentialing Specialist, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Medical Staff Credentialing Specialist, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)

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Medical Credentialing and Billing Specialist
  • MediTelecare
  • Middletown, CT FULL_TIME
  • MediTelecare is the nation’s leading telemedicine provider of behavioral health care to skilled nursing, assisted living and independent living facilities seeks an experienced full-time Revenue Collection Manager.   The Revenue Collection Manager (RCM) will manage the patient intake function and denial management functions. The daily functions of the RCM Manager include monitoring denials, working with an outsourced billing company, updating insurance information, KPI management, and managing the patient intake processes.

    Job Summary:

    The Medical Revenue Cycle and Enrollment Manager will manage the provider enrollment process of a Company operating in 26 states. The daily functions of the position include managing the credentialing/enrollment functions, monitoring denials, working with an outsourced billing company, updating insurance information, and KPI management.

    Duties/Responsibilities:

    • Medical front office or medical office operations experience required, ability to manage turn over, experience with interview, hiring and staff onboarding.
    • Review new provider enrollment information to determine all issues that need to be addressed.
    • Maintain provider information via provider enrollment software including demographics for all providers. 
    • Continually follow up with payers to ensure timely enrollment and participation, including revalidation dates.
    • Coordinate with internal team and outside Revenue Collection Management (RCM) company to monitor and manage key revenue cycle activities including billing, collections, payment posting, and rejection/denial management.
    • Proactively identify, troubleshoot, and resolve RCM issues to improve timeliness and effectiveness of the revenue cycle process.
    • Manage enrollment and credentialing personnel both internal and external to the Company.
    • Draft and implement processes and procedures to improve efficiency and accuracy.
    • Understand EHR/PM systems, patient scheduling, insurance requirements, pre-authorization requirements and impact on care delivery.
    • Data analysis skills using Excel (pivot tables)
    • Ability to identify and report on trends and patterns for the activities assigned to their department.
    • Utilization of KPIs to manage the department.
    • Performs other duties as assigned.

    Required Skills/Abilities:

    • Excellent verbal and written communication skills.
    • Excellent organizational skills and attention to detail.
    • Excellent time management skills with a proven ability to meet deadlines.
    • Strong analytical and problem-solving skills.
    • Ability to prioritize tasks and to delegate them when appropriate.
    • Ability to act with integrity, professionalism, and confidentiality.
    • Thorough knowledge of medical billing laws and regulations.
    • Proficient with Microsoft Office Suite.
    • Proficiency with Electronic Health Record Systems

    Education and Experience:

    • Bachelor’s degree in Business Administration, Human Resources or related field required.
    • At least 7 years of medical billing experience.
    • At least 3 years of experience managing a team.

     

     

  • 1 Month Ago

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Medical Site Credentialing Specialist- Independent Contractor, 1099
  • United Language Group
  • Middletown, CT CONTRACTOR
  • Summary - Flexible Contractor/Freelance Opportunity 1099 IMMEDIATE NEED This is not a full-time or part-time job. This is not a set-scheduled job opportunity. The Medical Site credentialing Specialist...
  • 1 Month Ago

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Credentialing specialist
  • Citizant
  • West Haven, CT FULL_TIME
  • Company Description Citizant is a leading provider of professional IT services to the U.S. government. We seek to address some of our country's most pressing challenges in the areas of Agile applicati...
  • 19 Days Ago

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Credentialing specialist
  • Citizant
  • Hartford, CT FULL_TIME
  • Company Description Citizant is a leading provider of professional IT services to the U.S. government. We seek to address some of our country's most pressing challenges in the areas of Agile applicati...
  • 19 Days Ago

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Credentialing specialist
  • Jobot
  • Greenwich, CT FULL_TIME
  • Join our team and take on the exciting responsibility of ensuring provider credentialing compliance while enjoying a dynamic work environment that values attention to detail and professional growth. T...
  • 20 Days Ago

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Credentialing Specialist
  • Yale New Haven Health
  • New Haven, CT OTHER
  • OverviewTo be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, a...
  • 1 Day Ago

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Credentialing Specialist
  • Green Key Resources
  • Miami, FL
  • ***This position has potential for remote/hybrid with training on site in 33183 ***Direct Hire Opening*** Pay:(flex depe...
  • 3/29/2024 12:00:00 AM

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Credentialing Specialist
  • Russell Tobin
  • New York, NY
  • Job Description Job Description Please find below details of the position. Position: Credentialing Specialist Location: ...
  • 3/29/2024 12:00:00 AM

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Credentialing Specialist
  • e-MDs
  • Hauppauge, NY
  • Summary of Job Responsible for preparing provider enrollment applications, demographic updates and tracking metrics for ...
  • 3/29/2024 12:00:00 AM

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Credentialing Specialist
  • N2S Healthcare Staffing Solutions LLC
  • Charlotte, NC
  • Title: Provider Services Specialist (Auto-Offer) Location: Charlotte, NC, 28208 Duration: 13 weeks Shift: Day 5x8-Hour (...
  • 3/28/2024 12:00:00 AM

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Credentialing Specialist
  • Atria Consulting
  • New York, NY
  • Busy New York City Hospital Corporation is looking for an experienced and organized Credentialing Specialist. The Creden...
  • 3/28/2024 12:00:00 AM

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Credentialing Specialist
  • PRIDE Healthcare
  • New York, NY
  • Job Description Job Description Role – Credentialing Specialist Location – New York, NY Shift – Day Pay - $25- $27/ hr C...
  • 3/28/2024 12:00:00 AM

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Credentialing Specialist
  • Infojini
  • Morristown, NJ
  • Job Description Job Description Position: Credentialing Specialist Location: Onsite: 475 South Street, AHS Corporate Off...
  • 3/27/2024 12:00:00 AM

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Credentialing Specialist
  • HEALTH NETWORK SOLUTIONS INC
  • Cornelius, NC
  • Job Description Job Description About Company: We are a privately-owned physician network in the Charlotte, NC Metro Are...
  • 3/26/2024 12:00:00 AM

Connecticut is bordered on the south by Long Island Sound, on the west by New York, on the north by Massachusetts, and on the east by Rhode Island. The state capital and fourth largest city is Hartford, and other major cities and towns (by population) include Bridgeport, New Haven, Stamford, Waterbury, Norwalk, Danbury, New Britain, Greenwich, and Bristol. Connecticut is slightly larger than the country of Montenegro. There are 169 incorporated towns in Connecticut.The highest peak in Connecticut is Bear Mountain in Salisbury in the northwest corner of the state. The highest point is just east...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Specialist, Sr. jobs
$54,543 to $67,076