- Requests all credentialing data and supporting documents from the physician. Communicate to the market onboarding team when delays with the physician are in jeopardy of interrupting the defined project timelines.
- Candidates should know NCQA standards, delegated credentialing, and Primary Source Verification.
- Prepare and/or update the provider's CAQH application for newly affiliated and existing healthcare providers.
- Ability to build and maintain peer-to-peer relationships with all relevant market Health Plans. Strategically communicate with newly affiliated providers to plan to initiate TIN change/demographic flip or initiate credentialing.
- Display in-depth knowledge of and execute all standard operating procedures (SOPs) as well as communicate issues, trends, and concerns to the Regional Supervisor.
- In-depth working knowledge of the various applications associated with all plans and the workflow process. Identify any opportunity for process improvement and work with the Regional Supervisor to challenge payors' agendas.
- Issue resolution relating to billing and collecting for services rendered. Educating internal markets on contractual obligations for each payor surrounding managing authorizations, billing requirements, and operationalizing language to ensure that we can bill and collect for services rendered.
- Provide credentialing information to Market Operations to ensure that they have the information needed to effectively manage the practices from a credentialing perspective.
- Minimum of four years of experience in a managed care role, centralized credentialing office, or related health care environment, such as credentialing or file maintenance.
- Knowledge of health plan and governmental payer credentialing, enrollment, and requirements.
- Knowledge of CAQH application.
- Knowledge of contract language interpretation and administration
- Demonstrated problem-solving and customer service skills.
- Knowledge of Microsoft Word and other PC applications.
- High School Diploma required; completion of an applicable Vocational or Technical training program preferred.
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Healthcare State Licensing Specialist
Found in: Lensa US 4 C2 - 6 days ago
CallonDoc Dallas, United States Full timeHealthcare Licensing Specialist (In-person/Full-time) · We are seeking a full-time Healthcare Licensing Specialist to join our team in Dallas, TX · Candidates must be located in DFW area for in person role. · Responsibilities: · Manage and organize the state licensing of med ...
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Healthcare State Licensing Specialist
Found in: Lensa US 4 C2 - 3 days ago
Callondoc Dallas, United States Full timeHealthcare Licensing Specialist (In-person/Full-time) · We are seeking a full-time Healthcare Licensing Specialist to join our team in Dallas, TX · Candidates must be located in DFW area for in person role. · Responsibilities: · Manage and organize the state licensing of medic ...
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Provider Data Specialist
Found in: Lensa US 4 C2 - 1 day ago
Healthcare Highways, Inc. Dallas, United StatesJob Description · Job Description · Roles and Responsibilities · The Provider Data Specialist is responsible for entering contracted providers and facilities into databases and communicating with different Healthcare Highways Departments for accurate and efficient data field up ...
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Manager, Global Trade Technology
Found in: Lensa US 4 C2 - 3 days ago
KPMG Dallas, United States**Business Title:** Manager, Global Trade Technology - SAP GTS · **Requisition Number:** · **Function:** Tax Services · **Area of Interest:** · **State:** TX · **City:** Dallas · **Description:** · At KPMG, you can become an integral part of a dynamic team at one of the world's ...
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Provider Relations Specialist
Found in: Lensa US 4 C2 - 6 days ago
IMS US (IMSUS) Dallas, United StatesJob Description · Job Description · Position Summary · The Provider Relations Specialist will help evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include es ...
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Tax Return Reviewer, Global Mobility Services
Found in: Lensa US 4 C2 - 4 days ago
KPMG Dallas, United StatesBusiness Title: Tax Return Reviewer, Global Mobility Services · Requisition Number: · Function: Tax Services · Area of Interest: · State: TX · City: Dallas · Description: · At KPMG, you can become an integral part of a dynamic team at one of the world's top tax firms. Enjo ...
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Senior Manager, Compensation
Found in: Lensa US 4 C2 - 6 days ago
KPMG Dallas, United StatesBusiness Title: Senior Manager, Compensation & Benefits · Requisition Number: · Function: Tax Services · Area of Interest: · State: TX · City: Dallas · Description: · At KPMG, you can become an integral part of a dynamic team at one of the world's top tax firms. Enjoy a co ...
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Advanced Practice Provider Special-PRN
Found in: One Red Cent US C2 - 6 days ago
Parkland Health and Hospital System (PHHS) Dallas, United StatesInterested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and ...
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Tax Senior Manager, Operating Partnerships
Found in: Lensa US 4 C2 - 6 hours ago
KPMG Dallas, United States**Business Title:** Tax Senior Manager, Operating Partnerships · **Requisition Number:** · **Function:** Tax Services · **Area of Interest:** · **State:** TX · **City:** Dallas · **Description:** · At KPMG, you can become an integral part of a dynamic team at one of the world's ...
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Manager, M&A Tax
Found in: Lensa US 4 C2 - 2 days ago
KPMG Dallas, United States**Business Title:** Manager, M&A Tax - Partnership Transactions Group · **Requisition Number:** · **Function:** Tax Services · **Area of Interest:** · **State:** TX · **City:** Dallas · **Description:** · At KPMG, you can become an integral part of a dynamic team at one of the w ...
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Adv Practice Provider II
Found in: Lensa US P 2 C2 - 3 weeks ago
Parkland Health Hospital System Dallas, United States OTHERInterested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and ...
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Technology Specialist
Found in: Lensa US 4 C2 - 6 days ago
BCG Attorney Search Dallas, United StatesA law firm in Dallas, TX, is seeking a Technology Specialist to provide expertise in patent matters, including patentability, freedom to operate, invalidity, and non-infringement analyses. This role requires the drafting of post-grant documents, advising litigation teams, and pro ...
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Senior Manager, International Tax
Found in: Lensa US 4 C2 - 3 days ago
KPMG Dallas, United States**Business Title:** Senior Manager, International Tax · **Requisition Number:** · **Function:** Tax Services · **Area of Interest:** · **State:** TX · **City:** Dallas · **Description:** · At KPMG, you can become an integral part of a dynamic team at one of the world's top tax f ...
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Manager, International Tax
Found in: Lensa US 4 C2 - 1 day ago
KPMG Dallas, United States**Business Title:** Manager, International Tax · **Requisition Number:** · **Function:** Tax Services · **Area of Interest:** · **State:** TX · **City:** Dallas · **Description:** · At KPMG, you can become an integral part of a dynamic team at one of the world's top tax firms. E ...
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Student Success Professional Development Coordinator
Found in: Lensa US 4 C2 - 6 hours ago
Dallas College Dallas, United StatesCurrent Dallas College employees will need to log into Workday through My Apps to apply. Simply enter "Find Jobs" in the Workday search bar to view open positions and submit your application. All Job Postings will close at 12:01 a.m. CT on the specified Closing Date. To view the ...
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Learning Management System Support Specialist
Found in: Lensa US 4 C2 - 11 hours ago
Signify Health Dallas, United States** Learning Management System Support Specialist (LMS Support Specialist)** · at Signify Health Remote This role will report to our Senior Manager - Onboarding & Education. · This position works to oversee the LMS and training process for new clinicians and clinicians requiring ...
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Learning Management System Support Specialist
Found in: Lensa US 4 C2 - 2 days ago
Signify Health Dallas, United States** Learning Management System Support Specialist (LMS Support Specialist)** · at Signify Health · Remote · This role will report to our Senior Manager - Onboarding & Education. · This position works to oversee the LMS and training process for new clinicians and clinicians requi ...
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Associate Endodontist
Found in: Jooble US O C2 - 5 days ago
Specialty1 Partners Dallas, TX, United StatesOur practice is currently looking for a Full-Time Endodontist to join our rapidly growing office. The Endodontic Group is a well-established, quality-oriented group practice limited to Endodontics, located in upscale communities in Dallas. Texas. Our objective is to provide Endod ...
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Manager of Approach and Authorization
Found in: Lensa US 4 C2 - 6 days ago
Southwest Transplant Alliance Dallas, United StatesGENERAL STATEMENT: (Summary of duties and responsibilities): · The Manager of Donor Services – Authorization is responsible for managing the day to day operations of the Donor Services Center. The Manager is responsible for the development and implementation of a cross-department ...
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Registered Vascular Technologist, Vascular Surgery
Found in: Lensa US P 2 C2 - 4 days ago
North American Vascular Biology Organization Dallas, United StatesWhy UT Southwestern? · With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. At UT Southwestern, we invest in you with opportunities for career growth and development that align with your f ...
Contract Credentialing Specialist - Dallas, United States - Wheeler Staffing Partners
Description
Wheeler Staffing Partners is hiring a Contract Credentialing Specialist on a contract basis with a healthcare client in Dallas, TX. The Sr. Credentialing Specialist will work closely with the local market onboarding team on all new providers in the pipeline. This is an on-site role, reporting to the Dallas office Mon-Fri.
Credentialing SpecialistJob Responsibilities:
Sr. Credentialing SpecialistJob Requirements:
WSP specializes in filling your company's contract, contract-to-hire, direct hire, contingency, and executive positions with professional candidates. From our Executive Retained Search Teams, Direct Hire and Contract Staffing Professionals, and RPO Service offerings we create models to deliver a world-class service, with a sense of urgency and professionalism. Our connections and our candidates combined with a staff backed by over 20 years of experience, ensure that our clients are seeing the right candidates for their career openings.
WSP is committed to creating a diverse environment and is proud to be an equal opportunity employer.
Contract Credentialing Specialist professionals in Dallas
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Christal Johnson
Customer Service Support/Receptionist