Credentialing Specialist - Remote work Job at Our Billing Co LLC, Buffalo, NY

OGZ0a3JXd2NkOVdsejhlNHBhRWlMaHlEVWc9PQ==
  • Our Billing Co LLC
  • Buffalo, NY

Job Description

****Our Billing Co. is seeking a Credentialing Specialist to join our team! The Credentialing Specialist is an important member of Our Billing Team. This individual is responsible for preparing the correspondence, gathering credentialing paperwork, and working with the credentialing vendor to file with the insurance. The Credentialing Specialist will coordinate with physicians, practice managers, practice directors, and executive-level leaders. Ultimately, the following functions serve to ensure no lapses of credentialing and to promote coordination with our vendor and Contracting teams to ensure coverage and participation with insurance for our patients and community. Essential Functions: Works with other department managers and staff—including physicians, managed care, contracting, and other professional staff—to acquire necessary materials and information for provider certification and licensure to promote organization-wide compliance with credentialing policies and procedures. Provides oversight of verification and payer credentialing of health care professions and credentials are in compliance with state and federal standards. Oversees process and organization of all-payer credentialing and re-credentialing paperwork with participating insurance companies. Maintains a database of practitioner’s training, education, licensing, and experience information. Key liaison with Medical Staff team, outside vendor, and IT for HIS system updates. Assists in filling out and reviewing applications with practitioners and other applicable staff Performs ongoing provider database maintenance for accuracy and completeness. Performs ongoing provider database maintenance for accuracy and completeness. Remains compliant with and knowledgeable of rules and regulations set forth by the Health Information Portability and Accountability Act (HIPAA), Joint Commission standards, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare & Medicaid Services (CMS), as well as state regulations—and relays this information to the necessary parties to ensure ongoing compliance organization-wide. Minimum/Preferred Qualifications: HS - High School Diploma or GED is required. AA - Associates of Arts is preferred. Minimum of two years of experience in physician credentialing is required. Knowledge, Skills and Abilities: Exemplary problem-solving and conflict-resolution skills. Detail-oriented. Skilled in synthesizing a wealth of information. Exhibits excellent time management and prioritization abilities. Communicates effectively both one-on-one and in a group setting. Capable of following and providing detailed instructions both orally and through written communication. Experience with credentialing database management software preferred. Extensive experience working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Access, Project). This job will be fully remote. Our Billing Co. offers a competitive benefits package! Pay Range: $24.00 - $30.00 Individual annual salaries/hourly rates will be set within job's compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and expertise of the individual and internal equity considerations. Our Billing Co LLC

Job Tags

Hourly pay,

Similar Jobs

Merge Investigations, Inc.

Private Investigator Job at Merge Investigations, Inc.

Looking for an experienced surveillance investigator who is able to work part-time for us as needed in the San Francisco/Bay Area. This could be worked around another part time job. Position Summary: The Surveillance Investigator position conducts assigned investigations... 

Veeva Systems, Inc.

Marketing Operations - Manager / Senior Manager (Boston) Job at Veeva Systems, Inc.

 ...customers, employees, society, and investors. As a Work Anywhere company, we support your flexibility to work from home or in the office, so you can thrive in your...  ...in Marketo marketing automation to segment our target prospects and ensure Veeva communications are... 

Community Choice Financial Family of Brands

Store Manager Job at Community Choice Financial Family of Brands

 ...Job Description Overview: As a Store Manager, you will leverage your leadership skills to coach, train, and guide your team to excel in their roles and uphold our high-quality standards. Reporting to the General Manager, you will serve as their right hand and run... 

Miller’s Downtown

Food Server Job at Miller’s Downtown

 ...based on tips - $17 to $30 an hour Main Responsibilities of a Food Server: Taking orders and delivering food and beverages....  ...exceptional customer experience. Food Server Job Description: Our restaurant is looking for a Food Server with remarkable hard skills and... 

Valmont Industries, Inc.

NDT Inspector - Associate (Evening Shift) (El Dorado) Job at Valmont Industries, Inc.

 ...NDT Inspector - Associate (Evening Shift) Join to apply for the NDT Inspector - Associate (Evening Shift) role at Valmont Industries, Inc. Continue with Google Continue with Google NDT Inspector - Associate (Evening Shift)3 weeks ago Be among the first 25 applicants...