Credentialing Specialist
Credentialing Specialist Healing Partners is a rapidly growing wound care management company based in the Mid-Atlantic region currently hiring a Credentialing Specialist who will assist in overseeing our physician and payer credentialing process.
We are looking for a highly motivated, organized individual with 1-3 years of credentialing experience to join our team.
Responsibilities:
Maintains the credentials of new and existing physician and mid-level providers, their medical licenses, DEA certificates and managed care applications.
Responsible for entering in ongoing data and supporting documentation for all providers within the internal credentialing and CAQH databases to ensure all expirable/personal information updates are current and correct.
Provides credentialing information for new facilities and new provider information with facilities.
Responsible for all CAQH (re) attestation requests, new location entries, and updating annual professional liability insurance renewals.
Acts as liaison between practitioners and payers, identifies delays with payers, escalates and communicates delays or issues timely.
Builds knowledge base for payer requirements and forms.
Maintains credentialing and provider information databases.
Administers payer website access (government, third party insurance, third party websites) for new and existing business office staff.
Complete payer enrollments for ERAs and EFT and maintains database of payers enrolled.
Works with leadership to apply and maintain in-network status with insurance companies for practice(s) and providers, as well as maintains a current provider roster list with in-network providers.
Complete any other duties assigned by management.
Qualifications:
A minimum one year of relevant experience in credentialing, provider enrollment, or related field required.
Excellent interpersonal skills Excellent communication skills both verbal and written.
Excellent organizational skills and an ability to manage follow-up efforts for multiple tasks.
Focused attention to detail to ensure accuracy and timeliness of credentialing information.
Ability to work under time constraints to meet deadlines.
Proficient use of Microsoft Office applications (Excel, in particular), internet resources and Adobe Acrobat.
Complying with HIPAA policies, LTC Healing Partners Policies and federal/state laws This position requires employees to be on-site/hybrid at our Sparks, Maryland location Recommended Skills Adobe Acrobat Attention To Detail Communication Coordinating Credentialing Databases Estimated Salary: $20 to $28 per hour based on qualifications.
We are looking for a highly motivated, organized individual with 1-3 years of credentialing experience to join our team.
Responsibilities:
Maintains the credentials of new and existing physician and mid-level providers, their medical licenses, DEA certificates and managed care applications.
Responsible for entering in ongoing data and supporting documentation for all providers within the internal credentialing and CAQH databases to ensure all expirable/personal information updates are current and correct.
Provides credentialing information for new facilities and new provider information with facilities.
Responsible for all CAQH (re) attestation requests, new location entries, and updating annual professional liability insurance renewals.
Acts as liaison between practitioners and payers, identifies delays with payers, escalates and communicates delays or issues timely.
Builds knowledge base for payer requirements and forms.
Maintains credentialing and provider information databases.
Administers payer website access (government, third party insurance, third party websites) for new and existing business office staff.
Complete payer enrollments for ERAs and EFT and maintains database of payers enrolled.
Works with leadership to apply and maintain in-network status with insurance companies for practice(s) and providers, as well as maintains a current provider roster list with in-network providers.
Complete any other duties assigned by management.
Qualifications:
A minimum one year of relevant experience in credentialing, provider enrollment, or related field required.
Excellent interpersonal skills Excellent communication skills both verbal and written.
Excellent organizational skills and an ability to manage follow-up efforts for multiple tasks.
Focused attention to detail to ensure accuracy and timeliness of credentialing information.
Ability to work under time constraints to meet deadlines.
Proficient use of Microsoft Office applications (Excel, in particular), internet resources and Adobe Acrobat.
Complying with HIPAA policies, LTC Healing Partners Policies and federal/state laws This position requires employees to be on-site/hybrid at our Sparks, Maryland location Recommended Skills Adobe Acrobat Attention To Detail Communication Coordinating Credentialing Databases Estimated Salary: $20 to $28 per hour based on qualifications.
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