Credentialing Team Lead

🔥 12 minutes ago

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Spectrum Billing Solutions

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

💸 Finance

🤝 B2B

Healthcare Insurance • Finance • B2B

Spectrum Billing Solutions is a company that offers industry-leading revenue cycle management services tailored for healthcare providers. They provide a comprehensive suite of services including verification of benefits, utilization review, billing, insurance collections, and patient collections. Spectrum is renowned for its ability to maximize reimbursement through persistent claims management and its strong focus on customer service. Their innovative dashboard reporting further empowers clients to make informed decisions and improve operations. With a focus on customization and efficiency, Spectrum Billing Solutions acts as a strategic partner to its clients, aiming to enhance their financial standing and streamline their operations.

📋 Description

• Complete provider credentialing and contract applications with third-party carriers and government health plans • Review provider credentialing and contracting information to ensure completeness and accuracy • Monitor applications and follow-up in a timely manner • Document, maintain and crosscheck client credentials in multiple databases, including CAQH and other third-party databases, as applicable • Create, update and track provider information in the internal credentialing system to ensure that credentials are completed timely and correctly • Research new state and payer information and guidelines • Serve as a go-to person for credentialing team • Assist with escalated credentialing matters • Meet or exceed required timeframes for provider communications, enrollments, and follow-ups • Maintain quality working relationships with internal and external customers

🎯 Requirements

• 3-5 years of experience in credentialing and contracting • Knowledge of Commercial Insurance and Government Payor guidelines • Ability to plan, organize, and complete work with competing priorities • Takes accountability for personal productivity and quality of output • Organized and detail-oriented with strong communication and problem-solving skills

🏖️ Benefits

• A close-knit team of talented and skilled individuals • Growth opportunities within the organization • Competitive salary • Healthcare benefits including medical, dental & vision, 401K • Flexible PTO