Our multi-physician, multi-location healthcare group needs your credentialing expertise.
Credentialing role would include:
Job Duties Include:
- Responsible for daily operations of the credentialing department. Developed, managed, and monitored processes and procedures to support the credentialing and re-credentialing
- Ensure timely renewal of licenses and certifications
- Responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical providers who provide patient care
- Prepare credentialing and re-credentialing applications on behalf of physicians/providers for submission to managed care companies and other agencies
- Maintain up-to-date for each provider in credentialing databases and online systems
- Anticipate any delays in the practitioner's credentialing process and communicate these issues with the team immediately
- Maintain necessary logs, lists, records, and current documentation required for physician/provider credentialing and re- credentialing to ensure requirements are met in a timely manner
- Contacts medical office staff, licensing agencies, and insurance carriers to complete credentialing and re-credentialing applications.
- Ensures compliance with accreditation standards and legal requirements related to the Medical staff.
- Communicates status regarding new applicants, privileging requests, special requests that arise.
- Accountable for all functions of the healthcare credentialing process to meet the health plan's requirements for employment as contracted medical professionals
- Managed Care Experience
- Contract Maintenance and Negotiation
- Working with insurance claims clearinghouse preferred (Navicure)
- Effectively communicating on the phone with inbound and outbound calls to reach positive resolutions
- Excellent communicator
- Work smart by multi-tasking
- Commitment to Customer Service
- Represent our client in a most professional manner
- Very organized and ability to focus
- Be able to promptly learn and utilize our system
- Prior experience necessary
Job Type: Full-time
- Medical Credentialing: 2 years
Out client offers a professional working environment, opportunity for growth, a competitive salary and an excellent benefits package including a 401K.