Credentialing Specialist Job at Catalyst Health Group
Job Summary
The
Credentialing Specialist supports operations and owns credentialing for the Provider Relations Team - working in conjunction with the Revenue Cycle Management Team. The role's primary functions include: network onboarding, provider opt in and credentialing, network record management, payer relations and operational support.
We are a culture that is unabashedly driven by purpose. We are making a difference to our patients and providers while growing at an accelerated rate. Every day, we support the health journey of patients by authentically living our core values: Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox.
We are a culture that is unabashedly driven by purpose. We are making a difference to our patients and providers while growing at an accelerated rate. Every day, we support the health journey of patients by authentically living our core values: Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox.
Role and Responsibilities
- Coordinates and owns the new provider onboarding process to ensure timely activation to payer contracts
- Manages network provider rosters to ensure accurate, timely data is provided to payers per network contract requirements
- Monitors network attribution per provider to ensure network members are accurately included in payer contracts
- Maintains accurate network records on a routine basis in Provider Relation's CRM tool
- Facilitates and ensures resolution of network provider issues related to payers including but not limited to credentialing, network status, contracting, billing and claims and attribution
- Manager and maintains network members records and documentation, as it relates to payer contracts, onboarding documents, etc.
- Collaborates with Provider Relations team to provide an excellent membership experience for network participants
- Supports Provider Relations team with operational items such as reporting, communication, and coordination with accounting department
- Performs ad hoc and root-cause analysis as directed by management
Qualifications and Requirements
- Associates Degree or equivalent work experience (Bachelor's degree a plus)
- 1+ years' experience in a physician's office or 3+ years related experience in health care environment serving in a credentialing role
- Strong communication skills, both written and verbal
- Basic Microsoft Office applications experience
- Value people; demonstrate professional respect and innovative mindset
- Team focus - working in a collaborative environment
- Confident in working with health care professionals and insurance payers
- Passionate about your work and move forward with purpose
- Ability to problem solve when the answer is not clear
Preferred Skills
- Computer literate and Microsoft Office applications proficiency
- eCW platform experience
- Medical Terminology
- Insurance carrier knowledge
- Large scale project management experience
- Ability to present issues to providers/clients with proposed solutions
Please Note :
www.bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.