Payor Credentialing Specialist

Job not on LinkedIn

🔥 4 minutes ago

🇺🇸 United States – Remote

💵 $27 - $29 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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GeneDx

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🧬 Biotechnology

🏥 Healthcare

🤖 Artificial Intelligence

Biotechnology • Healthcare • Artificial Intelligence

GeneDx is a biotechnology company dedicated to providing personalized and targeted medical care through genetic diagnosis. Leveraging one of the largest datasets for rare diseases, GeneDx offers advanced testing such as whole genome and exome sequencing. Their diagnostic solutions translate complex genomic information into actionable insights, facilitating personalized health plans, enhancing drug discovery, and improving the efficiency of healthcare systems.

📋 Description

• Assist in preparing and submitting credentialing applications for payors • Maintain and update credentialing databases and files, ensuring documentation is complete and accurate • Assist with payor portal updates and provide access for internal and external users as needed • Support EDI/EFT/ERA enrollment efforts with payors • Communicate with internal departments to gather information requested by payors • Assist in resolving credentialing issues or discrepancies • Stay informed about changes in payor requirements and regulations • Support the credentialing team with administrative tasks • Perform other related duties assigned by the supervisor

🎯 Requirements

• High School Diploma or GED required; bachelor’s degree preferred • Minimum of 1-2 years of experience in a healthcare administrative role, preferably in credentialing • Familiarity with Medicare, Medicaid, Managed Medicaid Care Organizations, and commercial/private health plans • Ability to identify and cultivate relationships with key points of contact to drive business objectives • Strong organizational ability, proficient communication skills, and excellent attention to detail • Ability to manage multiple tasks simultaneously in a fast-paced, deadline-driven environment • Proficiency in Microsoft Office Suite, Monday.com, and Salesforce preferred • Mathematical, computer, reasoning, and language skills at the professional level • Reliable high-speed internet access • Ability to sit for extended periods, use hands and fingers repetitively for typing and mouse operation, read computer screens and documents, communicate via phone and video calls, and occasionally lift up to 10 pounds

🏖️ Benefits

• Competitive compensation and benefits reflecting local market practices and legal requirements • Fully remote work from a home office or other suitable remote location • Flexible work schedule and hours established with the leader and adjustable to business needs • Reasonable accommodations for individuals with disabilities

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