Credentialing specialist [h1.location_city]

Every day we provide vital information that helps our clients and patients understand their health. Our team of expert pathologists believe in a collaborative approach to patient care centered on outstanding quality diagnostics and service to the Northwest medical community. Not only do we bolster our community, but we also provide numerous resources to our employees which help bring balance to the complexities of work and personal life through our wellness programs. If you are motivated about helping people and have a drive for service, then  Incyte Diagnostics  could be a great next career step!

About the Role :   We are seeking a highly organized and detail-oriented Credentialing & Payer Enrollment Specialis t to join our team. The successful candidate will be accountable for data collection, organization and submission of applications required by health plans, hospitals and governmental and other regulatory agencies. Works closely with individual practitioners, organizational leadership, Affiliated Hospitals Medical Staff, Payer’s Provider Relations Staff, Human Resources, and Billing Department to facilitate timely hospital credentialing and privileging, payer enrollment and re-enrollment, as well as expirables (state licenses, DEA, Board Certification, malpractice insurance, etc.), as required by governmental agencies and accreditation bodies.

You  Will :

• Maintain Credentialing and Payer Enrollment of Incyte Diagnostics’ PathologistsSuccessfully oversees the entire payer enrollment process through Pathologist’s onboarding (start date) and off boarding (exit date) (physician life cycle with Incyte)Maintains timelines enrollment schedules, communicates with Pathologist and other departments to update as needed, clarifies information requirements with internal and external stakeholders, and maintains strict level of confidentiality to provider the collection, tracking, verification, and maintenance of all pathologists’ information needed for enrollment, provider demographic updates, Incyte Diagnostics’ demographic updates, and payer contracting requirements. Payer Enrollment data includes but not limited to Medicare, Medicaid, private / commercial, and worker’s compensation payers electronic or paper enrollment and re-enrollment applications; licensure, certifications, and hospital affiliations; peer references & work history; practice
• Provide Administrative Support & Human Resources SupportProvides back-up for production and interpretation of pathologists' schedules, complying with corporate guidelines regarding time off, staffing, etc.; is able to determine staffing needs to resolve staffing issues, with travel needs for current and interviewing with new pathologist Onboarding to include communication with pathologist(s), scheduling onboarding meetings with staff and coordinating hospital of small hospital lab visit to include scheduling and production / distribution of reports of visit.
• Verify and maintain accurate provider information in compliance with industry regulationsSuccessfully oversees the entire hospital credentialing process through Pathologist’s onboarding (start date) and offboarding (exit date) (physician life cycle with Incyte)Maintains timelines credentialing schedules, communicates with Pathologist and other departments to update as needed, clarifies information requirements with internal and external stakeholders, and maintains strict level of confidentiality to provider the collection, tracking, verification, and maintenance of all pathologists information needed for credentialing, provider demographic updates, contracting, and other platforms as applicable. Credentialing data includes but not limited to education, post graduate training, sanctions (licensures; Medicare / Medicaid), work history, medical staff membership, peer references, NPI, licensures, DEA, Board Certification, CV, malpractice insurance, hospital privileges, activity reports and current clinical competence / ability to perform, continuing medical education (CME) and self-assessment modules (SAM), etc.
• Collaborate with medical professionals to ensure that all medical claims are processed accurately and efficiently
• Maintain up-to-date knowledge of industry regulations and requirements
• Communicate with healthcare providers to obtain necessary information and documentation

Education / Skills :

Minimum Qualifications

Preferred Qualifications

Pay Range : $21.21 - $29.70 USD  Hourly Annual  The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby / on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Generally, new hire offers will be between the minimum and midpoint of the salary range, depending on experience (DOE), with the ability to grow within the range over time.

Incyte Diagnostics is EOE : All qualified applicants will receive consideration for employment without regard to race, color, disability or protected veteran status.

We offer a competitive compensation and benefits package

For other opportunities, at Incyte Diagnostics :