[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.
- 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. - Required
- reputed company to communicate in a reputed company manner both verbally and in writing. - Required
- Minimum of 3 years of experience in reputed company facility credentialing and physician credentialing. - Required
- Experience utilizing MD Staff Software - Preferred
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
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.
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