102 Credentialing Specialist Jobs in United States

Talent Acquisition Team, May Institute
Randolph, MA | Full Time
$56k-73k (estimate)
2 Months Ago
Skin Cancer Institute
Cerritos, CA | Full Time
Just Posted
Kids S.P.O.T
Hollywood, FL | Full Time
$38k-48k (estimate)
Just Posted
Center Associates
Marshalltown, IA | Part Time
$83k-102k (estimate)
Just Posted
Physician Management Resources
Massachusetts, MA | Full Time
$43k-53k (estimate)
1 Day Ago
Physician Management Resources
Missouri, MO | Full Time
$37k-47k (estimate)
1 Day Ago
Physician Management Resources
New Hampshire, OH | Full Time
$37k-46k (estimate)
1 Day Ago
Group One Health, Inc.
Hardin, MT | Full Time
$47k-59k (estimate)
3 Days Ago
Thriveworks
Fredericksburg, VA | Full Time
$43k-53k (estimate)
3 Days Ago
Ga Foods
St. Petersburg, FL | Full Time
$54k-70k (estimate)
4 Days Ago
Quartet Health
New York City, NY | Full Time
$80k-104k (estimate)
4 Days Ago
Hunterdon Healthcare Partners
Pittstown, NJ | Full Time
$44k-55k (estimate)
5 Days Ago
Hunterdon Healthcare Partners
Califon, NJ | Full Time
$44k-55k (estimate)
5 Days Ago
Hunterdon Healthcare Partners
Port Murray, NJ | Full Time
$44k-55k (estimate)
5 Days Ago
Unique Orthodontics
Clovis, CA | Full Time
$39k-49k (estimate)
6 Days Ago
Portia International
Cynthiana, OH | Full Time
$38k-47k (estimate)
6 Days Ago
Portia International
Fairview, OH | Full Time
$37k-47k (estimate)
6 Days Ago
Le0020 Orlando Family Physicians, Llc
Orlando, FL | Full Time
$43k-53k (estimate)
1 Week Ago
Communicare Advantage
Akron, OH | Full Time
$35k-45k (estimate)
1 Week Ago
Excel Partners, Inc.
East Haven, CT | Temporary | Full Time
$44k-55k (estimate)
1 Week Ago
Hegira Health, Inc.
Livonia, MI | Full Time
$41k-51k (estimate)
1 Week Ago
Health Corner Pediatrics Llc
Tornillo, TX | Full Time
$47k-61k (estimate)
1 Week Ago
Any Baby Can Of Austin
Austin, TX | Other
$61k-80k (estimate)
1 Week Ago
Peninsula Community Health Services - Wa State
Bremerton, WA | Full Time
$50k-62k (estimate)
1 Week Ago
Thriveworks
Worcester, MA | Full Time
$41k-51k (estimate)
1 Week Ago
Terros
Phoenix, AZ | Other
$63k-83k (estimate)
1 Week Ago

Credentialing Specialist

$56k-73k (estimate)
Full Time 2 Months Ago

May Institute is an established nonprofit that wants to continue to make an impact. We are looking for a Credentialing Specialist to join our team. May Institute is a team of professionals committed to leading the continuous evaluation of organizational systems, through a team-oriented approach, in a collaborative effort to ensure practices are safe, effective, efficient, ethical, comply with established laws and industry standards, meet the needs and expectations of our customers, and promote the ongoing improvement of service outcomes and quality. Credentialing Specialist reports to the Billing Manager and would be working directly with our Home, School, and Center-based division.  WHO YOU ARE: ·An individual with a high degree of organization, attention to detail, follow through, and independence. ·The ability to interact effectively with employees at all levels in the organization and external stakeholders are critical to success in this position. ·This position plays an integral role in ensuring that payments for services rendered are received in a timely fashion, and that process related to contracting and credentialing are as effective and efficient as possible.   ESSENTIAL DUTIES AND RESPONSIBILITIES:  · Responsible for the accuracy and timeliness of the entire credentialing process of obtaining, reviewing, submitting, tracking provider applications and re-credentialing applications. ·Act as liaison to HR/Talent Acquisition and clinical practice supervisors on matters related to credentials, licensure, and provider numbers for billing third-party insurances for new and current employees.· Maintains quarterly audits on re-credentialing process of insurance contracts, insurance rosters, and CAQH status for clinical staff. · Interacts with internal departments to ensure systems have the proper insurance information (fee schedules) and that clinician credentialing is aligned with the terms of the payor contracts.·Works closely with senior third-party biller and Billing Manager for resolution in insurance denials for provider credentialing as well as contract/fee schedule discrepancies.·Carry out all job responsibilities and communications with respect and dignity and in accordance with May Institute policies and procedures. · A working knowledge of relevant local, state and federal laws and the related requirements of varying funding sources.    QUALIFICATIONS: ·At least three to five years experience·Third-party insurance experience a must·Bachelor’s degree preferred.·Must understand the nature and importance of confidential calls/situations and the ability to    handle with discretion.·Excellent oral skills.·Demonstrated ability to learn new concepts, processes, procedures and computer                  applications quickly and thoroughly.·Strong computer skill using Microsoft Office programs - Excel, Word, PowerPoint, and         database software. ·Knowledge of and skill in working with electronic records management software.

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If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Credentialing Specialist job description and responsibilities

A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.

03/14/2022: Des Moines, IA

A credentialing specialist can have certificates that will prove useful to their field.

02/01/2022: Newark, NJ

Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.

02/21/2022: Evansville, IN

Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.

02/01/2022: Las Cruces, NM

Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.

01/18/2022: Pueblo, CO

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Credentialing Specialist jobs

Credentialing specialists can often find work with a high school diploma or the equivalent.

01/25/2022: Kingsport, TN

Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.

03/01/2022: Parkersburg, WV

While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.

12/25/2021: Little Rock, AR

Make Use Of Advanced Software For Monitoring.

01/18/2022: New London, CT

Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.

01/31/2022: Portsmouth, OH

Step 3: View the best colleges and universities for Credentialing Specialist.

Butler University
Carroll College
Cooper Union
High Point University
Princeton University
Providence College
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