We’re seeking an experienced, highly organized and detail-oriented Credentialing Specialist to support credentialing and enrollment for medical and dental providers. Experience with major insurance carriers and a strong understanding of how to effectively enroll, negotiate fees and re-credential providers is a must. This role starts as a temporary position, with the opportunity to become permanent based on performance and business needs.
Responsibilities
• Research, prepare and maintain provider credentialing, enrollment, fee schedule negotiations and recredentialing of insurance participation applications.
• Verify licenses, education, work history, certifications, and other required documents.
• Review insurance contracts, fee schedule proposals and participation agreements
• Identify opportunities to improve reimbursement and negotiate until fees until an agreement is reached
• Maintain a detailed credentialing spreadsheet/database and monitor applications with insurance plans weekly for credentialing clients
• Keep provider files and credentialing databases accurate and up to date.
• Follow up on outstanding items and effectively communicate with providers and internal teams the status of the client’s credentialing process.
• Protect confidential information and meet deadlines.
Qualifications
• Previous experience in medical or dental provider credentialing
• Knowledge of insurance enrollment, CAQH, fee schedules and payer portals
• Strong organization, communication, and follow-up skills
• Comfortable handling confidential records and working with deadlines
• Ability to work independently with minimal supervision
• Proficient in Microsoft Outlook, Word and Excel
We are looking for someone who can take ownership of the credentialing process and keep our providers informed and happy while in the credentialing process.
Pay: $22.00 - $25.00 per hour
Expected hours: No more than 40.0 per week
Work Location: Remote