What are the responsibilities and job description for the Credentialing Specialist position at Element Medical Billing?
The Medical Billing Credentialing Specialist is responsible for collaborating the credentialing and re-credentialing processes for healthcare providers and facilities. This role ensures that all providers meet the necessary qualifications and are properly enrolled with insurance with commercial carriers. The specialist works closely with internal teams and external entities to maintain compliance and streamline the onboarding process.
Key Responsibilities:
- Coordinate and manage the credentialing and re-credentialing process for healthcare providers and facilities.
- Prepare and submit applications to insurance companies, government agencies, and other third-party payers.
- Monitor application status and follow up to ensure timely approvals.
- Maintain accurate and up-to-date credentialing files and databases.
- Communicate with providers to gather necessary documentation and respond to inquiries.
- Ensure compliance with state, federal, and payer-specific regulations.
- Collaborate with billing and administrative teams to ensure provider enrollment aligns with billing requirements.
- Track credentialing deadlines and proactively initiate renewals.
- Resolve issues related to denied or delayed credentialing applications.
- Assist in audits and reporting related to credentialing activities.
Qualifications:
- High school diploma or equivalent required
- Minimum of 2 years of experience in credentialing.
- Familiarity with insurance payer requirements
- Strong organizational skills and attention to detail.
- Excellent communication and interpersonal skills.
- Proficiency in credentialing software and Microsoft Office Suite.
- Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
Preferred Skills:
- Knowledge of healthcare compliance and regulatory standards.
- Prior experience in a medical billing company or healthcare facility.
Job Type: Full-time
Pay: $16.00 - $18.00 per hour
Expected hours: 40 per week
Work Location: In person
Salary : $16 - $18