Provider Enrollment / Credentialing Specialist at Growing Healthcare Services Company

We are an entrepreneurial company, looking for someone who is positive, flexible, committed, responsible, mature, a fast learner, a great communicator internal as well as external, open to ideas and direction and who will offer suggestions and solutions. This position offers an interesting, challenging and rewarding position in an environment with a path to advancement.

As Credentialing Specialist you will be responsible for provider credentialing and re-credentialing, Government and Commercial, initial applications, updates, and act as a liaison between the company, providers and payors.

Essential Functions:

  • Prepare, submit and follow up on all initial payer, re-credentialing applications and revalidation requests for providers and office locations
  • Ensure credentialing and licensing processes are completed and notifications sent timely
  • Review provider credentialing files and work with providers to obtain the necessary missing, incomplete and expiring items
  • Track current status of applications, follow up as necessary and document activity in an accurate and timely manner
  • Maintain and update provider files and rosters including but not limited to: internal provider and/or location data, individual CAQH profiles, payer databases, NPI database and Medicare database, and any other as needed
  • Maintains records of corporate provider contract files
  • Maintain consistent contact with providers to ensure that timelines and expectations are clear and requirements are completed timely
  • Advises management team and clients of any potential delays in a providers’ credentialing and works with billing operations staff in resolving billing issues related to payer credentialing issues
  • Establish and maintain professional relationship with client contacts, insurance providers, and billing operations staff
  • Stays abreast of current health plan and agency requirements for credentialing providers

Education, Training and Skills Required:

  • High School Diploma or equivalency certificate
  • 2+ years related credentialing experience desired
  • Knowledge of medical billing and insurance terminology highly desirable
  • Able to perform in a fast paced and high-volume position
  • Sharp attention to detail and thorough in completing tasks
  • Strong data entry skills- keyboarding/accuracy/speed
  • Working knowledge of Microsoft suite (i.e. Outlook, Word and Excel) and Adobe Acrobat
  • Excellent communication skills, verbal and written
  • Be a strong team player and displaying a good-natured, cooperative attitude
  • Ability to manage multiple streams of work simultaneously using good planning, organization, multi-tasking, and prioritization in order to meet deadlines

Being part of our team is many things – exciting, rewarding, fun and challenging. Because we are part of a dynamic industry there is a can-do, dynamic spirit, which inspires our people to keep pushing forward the boundaries for what we can accomplish for our clients.

We offer advancement opportunities for people with a client focused mind-set and the desire to make a positive impact. Working with us you will meet people with unique sets of skills, from a variety of cultures and we are always on the lookout for more talented individuals.

If you think we may be a fit for you, please reach out with your resume and an outline of your prior experience. We look forward to hearing from you!

To Apply to this job Please go to website address given in Source below
Source: https://job-openings.monster.com/provider-enrollment-credentialing-specialist-at-growing-healthcare-services-company-newton-ma-us-sbsc/199577973

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