Revenue Cycle Credentialing Specialist

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🔥 11 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $61.3k - $122.7k / year

⏰ Full Time

🟢 Junior

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Abbott

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1888

🏥 Healthcare

⚕️ Healthcare Insurance

🧬 Biotechnology

Healthcare • Healthcare Insurance • Biotechnology

Abbott is a global healthcare company committed to advancing medical technologies and improving lives around the world. It offers a broad range of leading products in diagnostics, medical devices, nutrition, and branded generic medicines. Abbott's innovations such as the FreeStyle Libre glucose monitoring systems and BinaxNOW rapid antigen tests are transforming diabetes management and COVID-19 response. Through its partnerships and initiatives, Abbott aims to foster health equity, improve access to healthcare, and address critical health challenges like malnutrition and infectious diseases. Abbott is also dedicated to sustainability and social responsibility, striving to make life-changing technologies accessible and affordable.

📋 Description

• Facilitate contract implementation by being proactive and reactive with internal and external parties to ensure the public and private payer contract paperwork and credentialing is in alignment with corporate goals, contracts, and/or regulations • Prepare and maintain credentialing files and reports for all payors and government entities • Expand both government and commercial payor profiles • Process and file applications with third party payors according to each payor’s individual requirements • Conduct all follow up steps until payor approval is obtained • Update NPI records according to provider specifications • Enroll provider in Medicare/Medicaid as prescribed by each program's requirements • Track licensure, accreditation, and insurance certificate expiration dates • Accept and process all requests from payers for credentialing information • Answer questions, inquiries, and process requests from all internal and external stakeholders related to credentialing information • Maintain historical data and files • Promote an open, collaborative environment built on trust to foster positive teamwork • Apply strong attention to detail, organizational, and analytical skills.

🎯 Requirements

• Associates degree in healthcare administration, public health, business administration, or related field; or high school degree/general education diploma and 2 years of relevant experience in lieu of Associates degree • 1+ years of contracting experience within the healthcare industry • Demonstrated knowledge of public and private Managed Care payers and reimbursement processes • Demonstrated understanding of market-related issues, contract development, negotiation, and pull through, as well as the legal and regulatory implications associated with private and government payer contracting • Basic knowledge of Microsoft Office; including Word, Excel, Access, Outlook, and PowerPoint • Demonstrated ability to perform the Essential Duties of the position with or without accommodation • Authorization to work in the United States without sponsorship.

🏖️ Benefits

• Health insurance • 401(k) retirement plan • Paid time off • Remote work options