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1 Credentialing Specialist Job in Clovis, CA

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Unique Orthodontics
Clovis, CA | Full Time
$39k-49k (estimate)
2 Months Ago
Credentialing Specialist
$39k-49k (estimate)
Full Time 2 Months Ago
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Unique Orthodontics is Hiring a Credentialing Specialist Near Clovis, CA

The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, commercial payers, Medicare and Medicaid.

RESPONSIBILITIES

  • Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
  • Maintain internal provider grid to ensure all information is accurate and logins are available
  • Update each provider’s CAQH database file timely according to the schedule published by CMS
  • Apply for and renew annually all provider licenses
  • Complete revalidation requests issued by government payers
  • Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid
  • Complete re-credentialing applications for commercial payers
  • Credential new providers and re-credential current providers with hospitals at which they hold staff privileges
  • Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing
  • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
  • Knowledge of provider credentialing and its direct impact on the practice’s revenue cycle
  • Excellent computer skills including Excel, Word, and Internet use
  • Detail oriented with above average organizational skills
  • Plans and prioritizes to meet deadlines
  • Excellent customer service skills; communicates clearly and effectively

SKILLS AND QUALIFICATIONS

2 years related work experience, outstanding financial & analytical skills, Proficient computer skills, Proficient with MS office excel, Outstanding communication skills both verbal & written, excellent people and organizational skills and detail oriented.

Preferred Skills

Edge software experience

Job Type: Full-time

Pay: $23.00 - $27.00 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Life insurance
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday
  • Weekend availability

Work Location: One location

Job Summary

JOB TYPE

Full Time

SALARY

$39k-49k (estimate)

POST DATE

01/26/2023

EXPIRATION DATE

02/24/2023

Unique Orthodontics
Full Time
$20-25 (estimate)
10 Months Ago

The job skills required for Credentialing Specialist include Customer Service, Billing, Life Insurance, Communication Skills, Organizational Skills, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing Specialist. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist. You can explore the career advancement for a Credentialing Specialist below and select your interested title to get hiring information.

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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
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