Position title
Medical Credentialing Specialist
Description
Our Medical Credentialing Specialists process credentialing and re-credentialing applications for medical providers and practices in order to assist our clients in credentialing and obtaining contracting with all commercial and government payors. This allows our clients to bill these payors as an in-network provider, resulting in an overall improvement in their revenue cycle management.
Responsibilities
- Assist the Credentialing Mangers with the overall credentialing and contracting process
- Obtain and verify all required and pertinent credentialing and re-credentialing documentation
- Assist with group and provider data entry into credentialing software (MD Staff and CAQH)
- Complete and submit applications for providers to be credentialed and contracted with payors
- Contact payors via phone and/or email to follow-up on applications to ensure timely
- completion
- Maintain and monitor all licenses and certifications in the database to ensure compliance
- within all markets
- Ensure all assigned facility and practitioner licenses and certifications are accurate and in
- good standing at all times
- Complete all forms and supporting documents required to obtain hospital privileges and/or
- reappointments for physicians, as necessary
- Ensure that all processing and reporting deadlines are consistently achieved
- Other related credentialing duties as assigned
Qualifications
- Excellent communication skills, both written and verbal
- Attention to detail
- Ability to work with in a fast-paced environment
- Proficient computer skills (Microsoft Office, Excel)
- Ability to multi-task and prioritize
- Self-motivated with initiative; willingness to learn and adopt new strategies
- Strong sense of ethics
- Some medical/healthcare industry experience
- 1-2 years of experience in business environment.
Screening Criteria:
- MUST HAVE STABLE EMPLOYMENT HISTORY.
- At least 1 year exp in medical/healthcare industry in BPO setup
Hiring organization
Connext
Job Location
Site Only, Angeles or Davao
