Title: Credentialing Specialists

Location: Canton, OH

Type: Full time

Reports to: Business Manager

CORPORATE OVERVIEW

We are a rapidly-growing company that currently serves numerous medical practices across the Akron-Canton area. We provide contracting, credentialing, coding, billing, accounting, and management services for medical group practices. The company uses a customer-focused approach to all services provided.

THE OPPORTUNITY

The Credentialing Specialists will work Monday through Friday, from 8:00 am to 5:00 pm. This is an exciting opportunity to join a growing company. This position will work directly with various managers and will be responsible for organizing, maintaining and verifying all aspects of the credentialing process for the multi-group practice.

RESPONSIBILITIES – ESSENTIAL DUTIES

Maintain deadlines on deliverables and communicate on an ongoing basis with Business Manager and internal clients – about contractual issues.

Credentialing Providers

• New Providers with multiple Insurance Carriers and hospitals
• Revalidations with multiple Insurance Carriers and hospitals
• CAQH
• PECOS
• NPPES

Ensure that contracts and proposals are properly entered into organizational databases and securely maintained.

Prepare reports, contracts, specifications, correspondence

Answer emails as needed, maintain contact lists and set as the point of contact for internal and external clients for credentialing matters.

Interact professionally with various levels of employees and outside representatives with effective oral and in written communication.

Coordinate with human resources and qualified employees to obtain new and updated documentation required for credentialing and recredentialing.

Document and maintain procedures and processes to ensure timely and efficient credentialing/recredentialing.

Enter data accurately into provider applications and attach appropriate documentation to applications as required and maintain information databases for qualified providers/consultants.

Submit completed credentialing applications for providers/consultants and track length of time for credentialing and recredentialing processes.

Maintain rosters for each location that will include providers, consultants, direct care and other staff.

Responsible for managing multiple credentialing projects and requests to meet goals and deadlines.

Working with Microsoft Excel, Word, and OneNote

Working with various software applications

Maintain a high level of organization in both paper and computer files

SKILLS

Credentialing experience especially in CAQH, PECOS

Excellent verbal and written communication skills, including the ability to compile, interpret and utilize information and to communicate effectively with people of all demographics and education levels.

Ability to work on multiple projects, deadlines and communicate the process. Must be able to prioritize workloads.

Ability to maintain confidentiality

Stable work history

Consistent attendance and punctual

Professional personal presentation

Proficient in Microsoft Office with a concentration in Excel and Word

Well organized and have excellent attention to detail and strong follow up skills

Ability to multi-task

Data entry experience helpful

Ability to solve problems and reason deduction

Willingness to learn, hardworking, positive can-do attitude

Must be able to be bonded

Must pass a drug test and background check before hire

EDUCATION-EXPERIENCE

1 or more years of contracting/credentialing experience

Bachelor’s degree preferable

WORK ENVIRONMENT

Office Setting

PHYSICAL DEMANDS

Sit at a computer desk for up to eight hours

View computer screen for up to eight hours

Type, listen and talk for up to eight hours

Some standing, walking, reaching, bending and lifting objects up to 50 pounds may be required

Excellent compensation package commiserates with experience.