Job Description
Description:
The Credentialing Specialist is responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process for established providers and new providers joining the medical group. The Credentialing Specialist must be able to work independently with minimal oversite, think freely, and work in a fast paced, high volume work environment. The Credentialing Specialist must also be able to multitask and prioritize executing in a timely manner, be meticulous, have effective communication skills, and always want to learn more.
Responsibilities:
· Collect credentialing and re-credentialing materials for providers.
PECOS and PAVE enrollment, DME revalidation changes and Medicare Renewal Revalidations
· Submit enrollments for providers with various payors.
· Follow up on enrollment statuses with payors.
· Maintain credentialing database & CAQH.
· Renew expirables, such as licenses & certifications.
· Submit notifications for offboarding providers and location changes.
· Monitor & maintain credentialing email.
· Manage Payor Portal emails and access.
· Additional duties assigned by the supervisor.
Requirements:• 2+ years of experience in credentialing and enrollments in various healthcare settings (physician office preferred).
• 2+ years in managing various insurance types: HMO, FQHC, PPO, IPA, Medicare PECOS, Medi-Cal PAVE.
• Medical billing experience preferred.
• Excellent customer service skills.
• Excellent written and verbal skills.
• Adaptability/Flexibility
• High diligence.
• Proficient Technical skills (including Microsoft Excel, Outlook, Word, Adobe PDF, & Internet)
• Works well with various software applications, such as CredStream, Cactus, and CredentialMyDoc.
• Works well as a team and independently.
• Positive “can do” attitude.
• Other duties as assigned.
Compensation Package
At BASS Medical Group, we understand that a comprehensive, high quality, and affordable health benefits program is now more essential than ever. The overall well-being of our employees is at the forefront of our focus. With this in mind, we offer our eligible employees a generous benefits program.
Health & Welfare Benefits: Medical through Anthem Blue Cross PPO, Low-Cost Dental and Vision, Medical FSA & HSA.
Retirement Savings & Income Security: Basic Life & AD&D Insurance, Long Term Disability, 401K plan with an employer contribution, Access to Financial Advisors, Identity Theft Program.
Work/Life Balance Benefits: Paid Time Off and Company Paid holidays, Life Assistance Program, Commuter & Parking Benefits, Secure Travel Services, Healthy Rewards Program, Will Preparation Program, Additional perks to include discounts for Cellular phone and Gym memberships.
Voluntary Benefits: Optional Life & AD&D Insurance, Aflac Supplemental Insurance, Pet Insurance
Reports To: Senior Credentialing Manager
Education
Some college no degree required or 2- 4 years of work experience.
Salary Range: $52,000-$66,560
Work Schedule : Monday-Friday 8:30am-5:00pm.
Start date: ASAP
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