Credentialing Specialist- Medical Payer

Credentialing Specialist- Medical PayerHealthPoint Family Care is currently hiring to add an additional credentialing specialist to the team.Position Type: Full Time Job Shift: Day Education Level: High School Category: Admin - ClericalDescriptionHealthPoint Family Care is currently hiring to add an additional credentialing specialist to the team. The position offers a retention bonus of $1,500 paid at 18 months of employment, with additional retention bonuses up to $4,000.

Benefits include two free sets of HealthPoint scrubs, tuition reimbursement for up to $1,000 a year, nine paid federal holidays, a birthday off paid in addition and not counted towards PTO, generous paid time off, and a wide array of benefit plans such as health, dental, vision, flexible spending accounts, Safe Harbor 401K Plan, long term disability, and group/voluntary life insurance plans.ResponsibilitiesAccurately tracks, records and collects necessary data from various sources to complete applications, renewals, revalidations and terminations.Responsible for coordinating the credential processes practitioners and facility in our growing healthcare practices.Maintains Provider credentialing files, initiates NPDB database inquiries, maintains NPPES and CAQH provider databases, and timely completion of Provider enrollment applications.Credential providers and facilities with Medicare, Kentucky and Ohio Medicaid and private payers for medical, mental health, women's health, dental and vision services.Tracks application status through timely follow-up to ensure enrollment.Responsible for processing of provider payor applications, initial, re-applications and attestations.Understands Medicare, Medicaid and commercial payor application process and EDI agreements.Maintain Credentialing files (paper and computer)Coordinates and participates in all phases of credentialing/re-credentialing profile process.Tracks and logs credentialing status routinely with participating networks.Review, update, maintain and report fee schedule for various payors within Group assigned.Aggressively collects, coordinates, reviews and documents performance data, which includes quality and utilization activities, member complaint data for re-credentialing purposes.Revenue Cycle projects as assigned.QualificationsOne year of experience in direct credentialing including primary source verification and completion of Medicare/Medicaid/commercial payer and hospital privileging applications. Applicants with less than one year experience will be considered with a training plan.Knowledge of Ohio and Kentucky Medicaid and Medicare credentialing requirements and systems.Proven methods for file maintenance and tracking required.Must be professional and detail oriented.Strong verbal and written communication skills.Intermediate level skills required in Microsoft Outlook, Word and Excel.Training in medical billing or a related field a plus