Credentialing Specialist

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

On-Site position