- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed.
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Maintains corporate provider contract files.
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Sets up and maintains provider information in online credentialing databases and system.
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies and other entities.
- Tracks license, DEA and professional liability expirations for providers.
- Maintains files and information in credentialing database.
- Audits health plan directories for current and accurate provider information.
- Enrollment or maintenance of online provider portals for demographic updates and verification of fees, and network status.
- Maintains confidentiality of provider information.
- Provides credentialing status and payer participation status for executive and sales teams as requested.
- Performs other duties as assigned.
- Remote Position in the Dallas or Austin, TX area
- Two years of relevant credentialing experience
- High school diploma or equivalent, associate degree preferred
- Certified Provider Credentialing Specialist (CPCS) desired
- Knowledge and understanding of the credentialing process.
- Ability to organize and prioritize work and manage multiple priorities.
- Excellent verbal and written communication skills including, letters, memos and emails.
- Excellent attention to detail.
- Ability to research and analyze data.
- Ability to work independently with minimal supervision.
- Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
- Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.
- Excellent Culture as ranked by our own employees
- (NPS Score)We Put the Patient First – Treating Others the Way We Want Ourselves or Our Family Treated.
- We Do the Right Thing...Team Matters – We Always Assume Positive Intent
- Health Insurance (Company pays approx. 70% of medical coverage chosen)Dental/Vision Insurance. (voluntary)
- Paid Time Off – tiered plan based on tenure starting at 120 hours annually
- Paid holidays – 7 days per year$50,000 life insurance/$50,000 AD&D Employer Paid (additional Voluntary Life/AD&D products available)Disability income protection plan (optional)
- 401(k) savings plan and company match
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Description
Job Description
Job DescriptionThe Credentialing Specialist is responsible for all aspects of the credentialing, recredentialing, and government programs enrollment processes for all medical providers who provide patient care for the practice. Responsible for ensuring providers are credentialed, with health plans. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.ADDITIONAL DUTIES & RESPONSIBILITIES
