Job Description Credentialing Specialist

Overview: We are seeking a detail-oriented Credentialing Specialist to join our team. The ideal candidate will have strong organizational skills, attention to detail, and an ability to learn the requirements for the credentialing process. This position plays a crucial role in ensuring the timely and accurate processing of insurance claims and maintaining compliance with credential requirements.

Responsibilities:

Credentialing:

• This position will report to the Fiscal Director, work collaboratively with the Human Resources/Compliance /Risk Departments.
• Support the credentialing process for providers, including APRN, PMHNP, therapists, and other allied health professionals.
• Complete and submit credentialing applications to insurance companies and other relevant organizations.
• Maintain up-to-date provider information in credentialing databases and tracking systems.
• Follow up on credentialing applications, track progress, and address any issues or deficiencies.
• Ensure compliance with credential standards and requirements set forth by regulatory bodies and insurance plans.
• Communicate with providers and insurance representatives to resolve credentialing-related inquiries or issues promptly.

Qualifications:

• Minimum of 2-3 years of experience working with insurance or billing related duties.
• Ability to learn credentialing, insurance billing and compliance/risk processes.
• Excellent computer skills, interpersonal skills, must have an assertive demeanor, integrity, and ethical practices along with exceptional customer service with coworkers.
• Strong analytical and problem-solving skills, with attention to detail and accuracy.
• Excellent communication skills, both written and verbal, with the ability to interact professionally with coworkers and stakeholders.
• Ability to prioritize tasks, manage deadlines, and work efficiently in a fast-paced team -oriented environment.
• Commitment to maintaining confidentiality of individuals served and provider information.
• Committed to working with integrity and ethical practices that support the company’s strategies.

Equal Opportunity Employer: We are an equal opportunity employer and value diversity in our workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

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Job Type: Full-time

Pay: $16.00 - $17.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: In person