Job Description:
• Complete enrollment and/or re-enrollment, revalidation applications for physicians, ancillary providers and facilities or groups with third-party payers and governmental programs (Medicare and Medicaid) as requested by the client in an accurate and timely manner
• Perform Primary Source Verification (PSV) services including but not limited to verification of licenses, malpractice and work history; perform PSV file audits as requested
• Complete, update and maintain Council for Affordable Quality Healthcare (“CAQH”) profiles for providers
• Maintain a Credentialing database in accordance with BerryDunn’s policies and procedures for all participating and non-participating providers with payer identification numbers and effective dates
• Partner with client liaisons, including billing departments to update the enrollment status of the providers
• Contact payers to follow up on submitted applications within BerryDunn’s policies
• Respond to various inquiries and requests for information from participating physicians, staff, hospitals, and managed care companies timely and with professionalism
• Communicate with providers or their designees to obtain requisite credentialing information to facilitate timely completion and submission of required documents
• Update client regularly on process and communicate any delays
• Continuously inform Credentialing leadership of the project status and assist in managing expectations related to deliverables and deadlines
• Be responsible for timely and accurately accounting of hours (billable and non-billable) in time and attendance software for proper billing of services rendered
Requirements:
• High school education required, bachelor’s degree preferred
• 3-5 years of relevant healthcare experience is required including specialized skills in Credentialing and/or Medical Billing
• Certified Provider Credentialing Specialist (CPCS), Certified Professional in Medical Staff Service Management (CPMSM), or Certified Provider Enrollment Specialist (CPES) certification a plus
• Ability to work independently, as well as, in a team setting
• Exceptional organization and time management skills to manage priorities and deadlines
• Effective verbal, interpersonal, and written skills
• Strong attention to detail and quality
• Proficiency with Microsoft Office suite (Word, Outlook, Teams) and Adobe; Excel preferred
Benefits:
• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off
• Remote work options