Credentialing Specialist

United StatesRemotemid

OtherCredentialing Specialist

0 views0 saves0 applied

Apply Now

Quick Summary

Key Responsibilities

To improve the lives of those we care for by redefining the care experience. Vision: To be the nation's preferred destination for pharmaceutical care of complex chronic conditions. Values: Be Kind.

Technical Tools

OtherCredentialing Specialist

About the Role

~1 min read

Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
Credential new providers and re-credential current providers with clinics at which they hold staff privileges
Responsible for facilitating the completion of all payer practitioner linking applications
Manage and maintain contracts, licenses and credentials for all current providers
Perform regular communication with payers including but not limited to receiving quarterly fee schedules, updates, and any additional relevant documentation
Develop, implement, and monitor processes and procedures to ensure the consistent delivery of quality contracting and credentialing services in an efficient and cost-effective manner
Ensure that the credentialing program is compliant with health plans, as well as State and Federal regulations including Medicare, Joint Commission, IMQ, AAAHC and other accrediting bodies
Track enrollment status with each required organization, agency, affiliate, and third-party payer
Maintain accurate provider profiles on CAQH, PECOS, and CMS databases
Maintain databases for all active provider files to include Verity and Availity
Credential new providers and re-credential current providers with clinics at which they hold staff privileges

Exceptional written and verbal communication skills, with a proven ability to interact effectively with a variety of external and internal constituents
Strong analytical and problem-solving skills
Ability to recognize and resolve ambiguous or conflicting objectives
Knowledge of provider credentialing and its direct impact on the practices revenue cycle
Proficiency with standard office software applications (Microsoft Office, Outlook, Teams, etc.)

Bachelors degree or equivalent work experience
3-5 years experience and demonstrated success in provider and facility contracting and credentialing with commercial and government payers
Certified Provider Credentialing Specialist (CPCS) certification preferred
Demonstrated experience in working with multi-site and/or multi-state providers
Experience with Infusion, G/I, Rheum, Neuro and/or large distributed medical practices desired

Pay is based on factors such as market location, job-related knowledge, skills, and experience, and is benchmarked against similar organizations in our size and industry. It is not typical for an individual to be hired at or near the top of the posted range, as compensation decisions depend on the facts and circumstances of each case. In addition to cash pay, full-time regular employees are eligible for 401(k), health benefits, and other company-provided benefits.

Credentialing Specialist Pay Range

$20—$26 USD

Nice to Have

~1 min read

What We Offer

~1 min read

Eligible employees may receive:

✓Medical, Dental, and Vision Coverage

✓Prescription Drug Coverage and Telemedicine Services

✓Health Savings Account (HSA), Health Reimbursement Arrangement (HRA), and Flexible Spending Options

✓401(k) Retirement Plan with Company Match

✓Life, AD&D, and Disability Insurance

✓Accident, Critical Illness, and Hospital Indemnity Coverage

✓Fertility and Family Planning Support

✓Tuition Reimbursement and Certification Assistance

✓Continuing Education and Professional Development Resources

✓Employee Assistance Program and Wellness Support

✓Paid Time Off

✓Volunteer Time Off and Charitable Giving Match

✓Employee Referral Bonus Program

IVX Health is proud to be an Equal Opportunity Employer. We are committed to creating an inclusive workplace where all employees are treated with respect and provided equal employment opportunities. Employment decisions are made based on business needs, job requirements, qualifications, merit, and applicable law.

IVX Health prohibits discrimination, harassment, and retaliation of any kind and is committed to providing reasonable accommodations to qualified individuals with disabilities and those with sincerely held religious beliefs.

Privacy Policy