ProviderPayer Credentialing Specialist
ProviderPayer Credentialing Specialist
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
At Anne Arundel Dermatology we give exceptional care to our patients and to eachother.
Patient First Caring Accountability Trust One Team Growth
Founded 50 years ago with a mission to provide the highest quality and full spectrum of medical surgical and esthetic skin care services to each and every one of its patients Anne Arundel Dermatology has assembled the finest group of dermatologists in the MidAtlantic and Southeastern states. With 280 clinicians and 110 locations in 7 states were thriving growing and looking to add talented individuals to our team!
Why join Anne Arundel Dermatology
We are committed to continual training and education for our physicians and staff. We are on top of the latest developments in dermatology including ongoing research emerging treatments new medications and prevention methods. You can find more than just a job with Anne Arundel Dermatology. We believe in providing our new associates with intensive hands on training and longterm career growth opportunities from within.
The Provider/Payer Credentialing Specialist coordinates and performs a variety of administrative duties that are for credentialing recredentialing and enrollment of both the clinicians and office locations with Medicare Medicaid and commercial insurance payers.
This position is a Remote with no more than 10 travel to the Support Center in Maryland. Must be located in the Eastern Time zone in order to be considered.
Salary range: 5565k
Responsibilities
Responsibilities include but are not limited to:
- Maintain and perform a warm friendly and welcoming relationship with all staff all medical and nonmedical professionals vendors and visitors
- Prepare submit and follow up on all initial payer applications for providers and office locations
- Prepare submit and follow up on all recredentialing applications for providers and office locations
- Contact and/or respond to requests for verification of credentials current licenses etc. ensuring credentialing and licensing processes are completed timely and notifications are sent timely
- Prepare submit and follow up on revalidation requests for providers and office locations.
- Review provider credentialing files and work with providers to obtain the necessary missing incomplete and expiring items
- Track current status of applications follow up as necessary and document activity in an accurate and timely manner
- Maintain and update provider files and rosters including but not limited to: internal provider and/or location roster lists individual CAQH profiles payer databases NPI Database and Medicare and Medicaid databases and any other as needed
- Maintain consistent contact with providers to ensure that expectations are clear and requirements are completed in a timely manner
- Establish and maintain professional relationship with insurance providers client contacts and credential personnel
- Ensure all PHI (Protected Health Information) remains confidential and is kept in a secure location at all times
- Complies with all health and safety regulations and requirements departmental policies procedures and objectives
- Other duties assigned as deemed necessary by management.
Qualifications
- At least 23 years experience with provider enrollment is required
- Experience with MDStaff a plus
- Excellent Customer Service Skills Interpersonal and Communication skills (both oral and written)
- Must have active listening skills and able to adapt to change
- Must be able to problem solve strong sense of decision making and judgment action oriented approachable
- Must be able to organize manage multiple projects at the same time
- Very strong knowledge and utilization in Microsoft Office Word and Excel
- Ability to maintain confidentiality and uphold the principles of compliance as outlined by the company
- Ability to work independently
Licensure/Certifications/Education
- High School Degree or Equivalent required. Associates Degree preferred.
- Experience with Credentialing software required
- Experience working remotely preferred
Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift 15 pounds at times.
Full time employees (defined as regularly working at least 30 hours per week) are eligible for the following benefits:
- Medical Dental & Vision insurance effective 1st of the month after date of start
- Shortterm and longterm disability Voluntary life (employee spouse and child) Critical Illness and Hospital Indemnity Effective the 1st of the month following date of hire
- Company provided Basic Life/AD&D insurance
- Paid time off
- Paid holidays
- Retirement Savings account
- Employee discount on cosmetic services and products
Required Experience:
Unclear Seniority
Employment Type
Full-Time
