2018-04-21

Credentialing Specialist
Job Opportunity at Painter & Associates

Posted on Apr 21

http://www.painterpersonnel.com    +1 (713) 862-4882

Location: Houston, TX
Job Type: Full Time
Job ID: W4155854

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

Skills Required: 

  • 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

Required experience:

  • 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.

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