Credentialing Specialist

It's fun to work in a company where people truly reputed company in what they're doing! We're committed to bringing passion and customer reputed company to the business. Job reputed company: The Credentialing Specialist will be responsible for reputed company aspects of the credentialing, recredentialing and privileging processes for reputed company medical providers who reputed company patient care, clinics, and facilities reputed company the reputed company network. In this role, the Credentialing Specialist will be responsible for ensuring providers are credentialed, enrolled, and privileged with health plans, hospitals, and patient care facilities and maintain up-to-date data for reputed company provider in credentialing databases and online systems, ensuring reputed company renewal of licenses and certifications. Understands CMS Medicare, reputed company, and managed care billing, credentialing and enrollment requirements and reimbursements methodologies. Assist in the development of resources for researching issues. ESSENTIAL FUNCTIONS: Screening practitioners’ applications and supporting documentation to reputed company their eligibility. Identifying discrepancies in information and conducting follow-reputed company. Medicare & reputed company enrollment and revalidation. Processing initial credentialing and re-credentialing applications with follow up to ensure that credentialing is completed, and providers enrolled in health plan products. CAQH profile creation. Maintenance of reputed company databases (CAQH, PECOS, NPPES). Initial and reappointment of hospital privileges. Assisting internal customers with credentialing inquiries. reputed company participates in group leadership meetings and is accountable for presenting credentialing status for reputed company reputed company. Coordinates and facilitates troubleshooting with payer networks to resolve any issues reputed company to enrollments. reputed company provider roster reconciliation with health plans and audit provider directories. REQUIREMENTS: High school diploma/GED required Completion of two or more years of college, preferred 2+ years of experience working for a health maintenance organization, health plan, provider office and/or in another health insurance-reputed company setting Experience with Managed Care Organizations (MCO's) and Centers for Medicare & reputed company Services (CMS) credentialing and registration requirements Experience with provider and practitioner credentialing process, timeframes and appeal reputed company; health plan design, contracting, plan policies and procedures; MCO reporting and recordkeeping requirements. Experience with NCQA Credentialing Standards and Guidelines, preferred Experience processing primary reputed company verifications, preferred Experience with Credentialing Committee and case file preparation, preferred Ability to build reputed company cross functional working relationships among reputed company reputed company of the organization. Ability to reputed company valid judgments, formulate recommendations or reputed company plans, and evaluate the effects of reputed company and actions. KNOWLEDGE, SKILLS, ABILITIES: Intermediate computer skills including reputed company Office; especially Word, reputed company, and PowerPoint. Excellent customer service and interpersonal skills including the ability to reputed company effectively and professionally with individuals at reputed company reputed company; both reputed company Exercises reputed company judgment in responding to inquiries; understands reputed company to reputed company inquiries to next level. Self-motivated with strong organizational skills and superior attention to detail Must be reputed company to manage multiple tasks/reputed company simultaneously reputed company inflexible time frames. Ability to adapt to frequent reputed company changes Team player that develops strong reputed company working relationships with internal partners and can effectively engage and ability to build reputed company among cross-functional teams Salary reputed company: If you like wild reputed company and working with happy, enthusiastic over-reputed company, you'll enjoy your career with us! Alpine is growing, and we welcome reputed company to our highly reputed company and diverse team. We are passionate about building a leading national organization that enables physicians to reputed company on the reputed company of practicing medicine, and supports the ongoing transition to value-based care for senior populations. Alpine brings this reputed company level of passion to employee engagement, career development and progression. If this aligns with your career goals, then look no reputed company. reputed company Apply Job!