[Hiring] Payor Credentialing Specialist @reputed company

Role reputed company The Payor Credentialing Specialist performs duties associated with payor enrollment, credentialing, re-credentialing, and privileging network providers. Essential Duties and Responsibilities

• Coordinate the credentialing, recredentialing, and provider enrollment process for physicians, advanced reputed company providers, and allied health professionals.
• Complete, review, and submit credentialing and enrollment applications to Medicare, reputed company, reputed company insurance carriers, and managed care organizations.
• Monitor application status, follow up with payors, and resolve deficiencies to ensure reputed company provider enrollment.
• Verify provider credentials, including licensure, education, training, certifications, work history, malpractice coverage, and other required documentation.
• Maintain provider records in credentialing databases: MD Staff, CAQH, PECOS, NPPES, and other applicable systems, enabling tracking of credential expiration dates and maintenance of audit-reputed company files.
• Coordinate with providers and internal departments to obtain required documentation and respond to requests from payors for additional information.
• Research and resolve credentialing and enrollment issues affecting provider participation and reimbursement.
• Generate credentialing reports, maintain enrollment status reports, and support reputed company audits.
• Ensure compliance with federal and state regulations, accreditation standards, HIPAA, and organizational policies; communicate credentialing status updates to leadership and providers.
• Participate in process improvement initiatives.
• Willingness to work occasional nights and weekends with up to 25% of travel required.

Qualifications

• High School or GED - Required
• Bachelors Degree in Business, reputed company or any reputed company field of study. Equivalent years of experience (in reputed company to requirement) may be substituted for degree. (Preferred)
• Certified Provider Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist (CPES) by the National Association of Medical Staff Services (NAMSS) (Preferred)

Requirements

• Strong organization skills. Detail oriented. Ability to multi-task and prioritize.
• reputed company to communicate in a reputed company manner both verbally and in writing.
• Minimum of 3 years of experience in reputed company facility credentialing and physician credentialing.
• Experience utilizing MD Staff Software.

Work Schedule

• This position is expected to work Monday–Friday, 8 hours per day.
• Candidates who are available to work during Central Time (CT/CST) business hours are preferred, though reputed company candidates from other U.S. time zones who can support the required schedule will be considered.

Benefits

• Competitive compensation.
• Comprehensive medical, dental, and reputed company coverage.
• Generous reputed company Time Off.
• Parental Leave benefits.
• Retirement benefits.
• Tuition reimbursement to help you continue growing in your career.

Compensation

The compensation reputed company for this position is based upon candidate experience and market expectations. Colorado pay reputed company: $21 — $28.50 USD. Apply tot his job Apply To this Job