Credentialing Specialist - Portage, United States - Ascend Practice Management
Ascend Practice Management
Portage, United States
Verified Company
3 weeks ago
Description
Credentialing and Contracting Specialist
Overview:
Educational Requirements:
- High School Diploma or G.E.D.
Experience Required:
Minimum of 3 years non-clinical medical office experience with the skills below:
Areas of Responsibilities:
1.
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Credentialing:
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- Manage the endtoend credentialing process for healthcare providers, including physicians, nurses, and allied health professionals.
- Collaborate with providers to gather necessary documentation and information for credentialing purposes.
- Conduct thorough verification of professional licenses, certifications, and relevant credentials.
- Track and monitor credentialing status, ensuring ongoing compliance with organizational and regulatory requirements.
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Contracting:
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- Facilitate contract agreements with insurance providers, payers, and managed care organizations.
- Collaborate with legal and compliance teams to review and finalize contractual documents.
- Ensure that contract terms align with organizational goals and industry standards.
- Maintain updated knowledge of healthcare regulations and reimbursement policies to inform contract negotiations.
- Monitor and manage contract renewal processes, ensuring timely updates and renegotiations when necessary.
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Database Management:
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- Maintain accurate and uptodate provider information in the credentialing and contracting databases.
- Develop and implement efficient data management processes to streamline credentialing and contracting workflows.
- Generate reports and analytics related to credentialing and contracting activities.
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Compliance and Quality Assurance:
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- Stay informed about industry changes and updates related to credentialing and contracting.
- Conduct internal audits to ensure compliance with accreditation standards and regulatory requirements.
- Collaborate with internal stakeholders to address and resolve any compliance issues.
Qualifications:
- Proven experience in credentialing and contracting within the healthcare industry.
- Strong understanding of healthcare regulations, accreditation standards, and reimbursement policies.
- Excellent negotiation, communication, and interpersonal skills.
- Detailoriented with exceptional organizational and timemanagement abilities.
- Proficient in using credentialing and contracting software and databases.
Benefits:
- Competitive salary
- Employer Paid Healthcare Reimbursement Program (QSEHRA)
- Tuition Reimbursment
- Employer Paid Life and AD&D Insurance Policy
- Flexible Paid Time Off
- Professional development opportunities
- Positive and collaborative work environment
Pay:
$ $22.00 per hour
Expected hours: 40 per week
Benefits:
- AD&D insurance
- Flexible schedule
- Flexible spending account
- Life insurance
- Paid time off
- Tuition reimbursement
Schedule:
- Monday to Friday
Experience:
- Credentialing & Contracting: 3 years (required)
Work Location:
Hybrid remote in Portage, IN
