Credentialing Specialist
Keplr Vision has an immediate for a professional Credentialing Specialist in our Field Ops department. (REMOTE)
Summary/Objective
The credentialing specialist develops and maintains an ongoing collaborative relationship with providers, based on mutual respect, high quality outcomes and patient satisfaction. The Credentialing Specialist is responsible for provider enrollment and credentialing with all payers. Primarily, the Credentialing Specialist will be responsible for each application from initiation to approval and ongoing maintenance of provider enrollment and credentialing.
Primary Function
Ongoing, professional, and effective touchpoints with all active providers
Provide high level of customer service
Ensure accurate ongoing collection of key provider data element updates and changes
Performs updates to the provider database on a regular basis to ensure compliancy
Responsible for provider contract administration to ensure that all contract providers have a current and valid contract on file with all participating health plans
Supporting providers through the credentialing/re-credentialing process, including addressing provider questions, and ensuring timely completion of applications
Responsible to develop relationships with all Health Plans
Coordinates and ensures all necessary logistics obtained to support a successful implementation (contracts, EMR access, onsite access, etc.)
Ensures provider compliance with all state and federal programs
Proactive identification and resolution of plan gaps within a practice
Other credentialing, support and compliance duties as assigned
Minimum Qualifications/Requirements
2 - 3 years administrative experience in the healthcare field preferred
At least 2 years in Provider Enrollment
Minimum High School diploma or GED
Highly organized with attention to detail
Ability to effectively prioritize multiple tasks and deadlines, with flexibility and capacity to identify and administer competing operational priorities in a changing environment with creativity and resourcefulness
Excellent verbal, interpersonal, judgment and problem-solving abilities
Ability to undertake assignments with minimum supervision and direction
Equal Opportunity Employer
Apply Now
Summary/Objective
The credentialing specialist develops and maintains an ongoing collaborative relationship with providers, based on mutual respect, high quality outcomes and patient satisfaction. The Credentialing Specialist is responsible for provider enrollment and credentialing with all payers. Primarily, the Credentialing Specialist will be responsible for each application from initiation to approval and ongoing maintenance of provider enrollment and credentialing.
Primary Function
Ongoing, professional, and effective touchpoints with all active providers
Provide high level of customer service
Ensure accurate ongoing collection of key provider data element updates and changes
Performs updates to the provider database on a regular basis to ensure compliancy
Responsible for provider contract administration to ensure that all contract providers have a current and valid contract on file with all participating health plans
Supporting providers through the credentialing/re-credentialing process, including addressing provider questions, and ensuring timely completion of applications
Responsible to develop relationships with all Health Plans
Coordinates and ensures all necessary logistics obtained to support a successful implementation (contracts, EMR access, onsite access, etc.)
Ensures provider compliance with all state and federal programs
Proactive identification and resolution of plan gaps within a practice
Other credentialing, support and compliance duties as assigned
Minimum Qualifications/Requirements
2 - 3 years administrative experience in the healthcare field preferred
At least 2 years in Provider Enrollment
Minimum High School diploma or GED
Highly organized with attention to detail
Ability to effectively prioritize multiple tasks and deadlines, with flexibility and capacity to identify and administer competing operational priorities in a changing environment with creativity and resourcefulness
Excellent verbal, interpersonal, judgment and problem-solving abilities
Ability to undertake assignments with minimum supervision and direction
Equal Opportunity Employer
Apply Now