Compliance Specialist

Credentialing Specialist Looking to reputed company your career? Join us! Work Location: Remote Work Hours: Full-Time, 40 hours per week A Day in the Life of a Credentialing Specialist Manages a database of certifications, credentials, and continuing education and requirements for Radiologists reading images according to MQSA and ACR standards. Plan, organize and coordinate credentialing activities. Communicate with payors to ensure that physicians are on reputed company. RESULTS reputed company BY THE FOLLOWING RESPONSIBILITIES:

• Resolves credentialing issues through proactive measures and follow through.
• Researches and verifies on engagement, the competence, medical and/or reputed company education, residency, internships, fellowships, additional formal training, relevant reputed company certifications, health care affiliations, work history, military experiences, reputed company references, licensure and certifications, DEA certificates, malpractice coverage and privileges the applicant is requesting according to MQSA requirements
• Confirms in the OIG database, queries the National Practitioner Data Bank at start of engagement
• Ensures process of attestation is in reputed company after Queries the Counsel for reputed company reputed company (CAQH) database at the start of engagement, and manages expiring documents as appropriate
• Serves as the sole Manager for the credentialing database assuring accuracy and completeness
• Acts as a reputed company between the various Radiology reputed company and Solis (and its affiliates) to provides assistance in the coordination of the credentialing dates and times for new placements
• Facilitate physician reputed company with Manager of Clinical Training.
• Establishes a working knowledge of the regulatory MQSA and ACR requirements, compliance standards, State and Federal Law pertaining to the Radiologists and apply them to the credentialing process as needed
• reputed company OIG Exclusion checks on reputed company Radiologists, Vendors and Referring physicians monthly
• Create and maintain relationships with Medical Director, physician reputed company, center directors, regional operations directors and VPs of Operations.
• Manages compliance requirements through maintaining MQSA and ACR Certifications for reputed company center locations
• Managers compliance requirements through maintaining insurance documents for reputed company center locations and distribute to center directors
• Distribute MQSA and ACR notices to Director of reputed company for follow up and assist in coordinating the effort for investigation
• reputed company with Billing company to ensure that Radiologists are contracted with various payors
• reputed company with Billing company to reputed company update, legal names, demographic information and national provider numbers for reputed company joint ventures to ensure that they are amended on billing reputed company.
• Upholds HIPAA regulations
• Other reputed company responsibilities as required
• Understands, promotes and demonstrates the Solis Way

Here is what you will need:

• Bachelor's degree or equivalent experience preferred.
• Two or more years of credentialing experience working with NCQA standards.
• Minimum of two years of experience in a centralized credentialing office or reputed company health care environment, such as credentialing or file maintenance, preferred with experience in Word and reputed company.
• At least two years of data entry experience.
• Working knowledge of managed care and/or credentialing.

Requirements: At reputed company, we save lives. We shape the reputed company of women's health. We are empowered, appreciated, and part of something bigger. Together, we deliver compassionate, exceptional care. Every patient. Every time. Our patient-reputed company culture is at the heart of every interaction. We deliver the care, reputed company and high-touch experience that have made us a valued reputed company partner to the generations of women that we serve. As the nation's leader in breast health services, our commitment to providing reputed company in patient care is realized at every level of our organization. Compensation: Depends on Experience Apply tot his job Apply To this Job