Job Details
Level
Experienced
Remote Type
Fully Remote
Position Type
Credentialing Specilalist
Education Level
High School Graduate or Equivelant
Travel Percentage
No Travel
Job Shift
Monday thru Friday
Job Category
Health Care
Description
Are you interested in working with an authentic team who care about their clients and employees? PBS is committed to excellence in revenue cycle, practice improvement, and service to physician practices. We are looking for experienced, talented individuals who value integrity, innovation and teamwork.
Position Summary:
The Payor and Provider Credentialing Specialist will be responsible for enrolling and maintaining providers and groups with contracted payors, updating demographics as needed, establishing enrolling in EFT with payors, and other misc. tasks assigned.
Primary Job Duties:
The Specialist is able to work at a level that is mostly independent with minimal training or oversight needed. They will complete the following tasks for their assigned clients/providers:
- Accountable for all aspects of enrollment including provider enrollment, group enrollment, demographic updates, EFT enrollment to accurately submit claims and receive revenue from insurance payors across assigned clients.
- Maintains all provider data and documents related to payor enrollment and credentialing; responsible for knowing and understanding deadlines, which may not be communicated directly from the payor, client, or manager.
- Completing payer initial and recredentialing applications completely and accurately, with a minimum of errors while following payer enrollment process and guidelines. Communicate details when requested.
- Complete demographic changes and location updates for clients when/if necessary.
- Understanding online portals, ability to obtain access, assign and terminate users as needed.
- Other duties as assigned.
Competencies
- Understanding of physician credentialing and payor enrollment requirements across multiple states and payors.
- Excellent organizational skills including utilizing project management/task management software. Proven ability to lead by prioritizing responsibilities to meet daily/monthly and long-term performance goals.
- Ability to gather data using internet research efficiently and effectively and online with minimal supervision.
Qualifications
Required Education and Experience
- High school diploma or GED (General Educational Development) diploma.
- 2 years or equivalent experience in payor enrollment and/or credentialing or demonstrated competency.
Preferred Education and Experience
Experience with Asana and Acorn platforms preferred.
