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Credentialing Specialist

Enhanced Revenue Solutions Inc
25700 Interstate 45, Spring, TX 77386
Remote
$21 - $23 an hour - Full-time

Location

25700 Interstate 45, Spring, TX 77386

Benefits
Pulled from the full job description

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Flexible schedule
  • Health insurance
  • Health savings account

Full job description

Enhanced Revenue Solutions, Inc by Infinx Healthcare

Join the fast-growing team at ERS by Infinx Healthcare, as we transform healthcare reimbursement and revenue cycle. For too long healthcare providers have struggled with healthcare payments, revenue leakage and reimbursements. This leads to less-than-ideal conditions for patient care and satisfaction. Our solutions and people remain focused on improving the revenue cycle continuum so that healthcare providers can take care of patients while we ensure they get paid. We work with the leading hospitals, health systems and physician groups across the country.

Good talent is the bedrock of our success. So, we treat our talent well, developing individual capabilities, kindling an entrepreneurial spirit, and ensuring that everyone has a rewarding and productive career here. That’s just part of our DNA. And it’s evidenced everywhere, from our fun and flexible work culture to our generous salaries, benefits packages, and defined career paths.

Working Hours Required 8:00 am - 5:00 pm CT

Onsite Location: Hyrbid/Remote

Summary Description:

Under general direction, this position will provide full-service credentialing for applications for insurance carriers, doctor facilities and hospitals. Persistent follow-up and follow-through are a requirement. Utilize a variety of proprietary and external tools in order to research and resolve provider enrollment issues. This may require contact with the payer networks, operation personnel and/or insurance companies via phone, email or website.

Daily Responsibilities:

  • Credentialing Documentation: Maintaining all pertinent Credentialing documentation (e.g., DEA, CDS, Medical Licenses, Board Certificates, Malpractice Insurance Face Sheets, CMEs, etc.)
  • Distribution of Renewed Documentation: Ensuring that all renewed documents (including DEA, CDS, Malpractice Insurance Face Sheets, Medical Licenses, updated CMEs, etc.) are updated at each insurance carrier and hospital
  • Document Tracking: Tracking with advanced notification of expiring licenses for DEA, CDS, etc. to act as the liaison between the practice and the insurance carriers and hospitals with all matters relating to the credentialing / recredentialing process
  • Create a detailed insurance matrix for each practitioner which lists the individual physician, each insurance carrier and the physician’s status with the plan, (updated each time there is a change in status)
  • NPI (National Provider Identifier) Management: NPI implementation and Maintenance in the NPPES system.
  • Performs follow-up with Physicians, Insurance carriers as needed in order to research and resolve provider enrollment issues.
  • Performs follow-up with insurance payers via phone, email or website to resolve payer credentialing issues.
  • Manage the completion and submission of provider enrollment applications.
  • Work closely with site management and resources to expedite completion of forms and requirements including obtaining signatures, locating required documentation, etc.
  • Establish close working relationships with privileged coordinators, contracting department, medical management, and payer contacts.
  • Understand specific application requirements for each payer including prerequisites, forms required, form completion requirements, supporting documentation and CMS/Medicare guidelines.
  • Maintains strict confidentiality regarding protected health information.
  • Perform administrative and technical duties to support the credentialing functions of initial appointment, reappointment, the granting of clinical privileges, and maintenance of expirable in accordance with hospital medical staff bylaws and credentialing policies and procedures
  • Work to ensure that timely and accurate initial and reappointment applications are presented to the department chairs/credentials committee/medical executive committee for review
  • Populate, maintain, and update credentialing software including accountability for the integrity of credentialing information entered in the credentialing data tracking system, Intellicred

Skills and Education:

  • Knowledge of latest technologies pertinent to the ERS discipline.
  • Min of 2 years of medical credentialing experience
  • Knowledge of industry trends pertinent to the ERS discipline
  • Knowledge of depth experience and exposure to the healthcare provider industry and demonstrate knowledge of hospital operations and systems
  • Knowledge and understanding of business principles, processes and technology.
  • Ability to plan and manage multiple activities in a diverse and evolving environment.
  • Excellent communication skills (written and verbal) and strong organizational skills.
  • Strong organizational skills; attention to detail and good group presentation skills.
  • Experience in proven client interaction skills with a focus on account management, business development
  • Proficient in business communication – written and oral and excellent documentation skills
  • High proficiency in MS office suite, specifically excel and PowerPoint
  • High school diploma

Job Type: Full-time

Pay: $21.00 - $23.00 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Flexible schedule
  • Health insurance
  • Health savings account
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Ability to commute/relocate:

  • Spring, TX 77386: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

  • By submitting your resume for this role, you certify that all information included in your resume is accurate and true.

Education:

  • High school or equivalent (Preferred)

Experience:

  • Credentialing: 3 years (Required)
  • Implemetation: 2 years (Required)

Work Location: In person