Credentialing Specialist

Job not on LinkedIn

🔥 4 minutes ago

🇺🇸 United States – Remote

💵 $15 - $21 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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Franciscan Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1875

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Franciscan Health is a healthcare organization committed to providing high-quality medical care grounded in the Franciscan tradition. They offer a range of medical services, including clinical and allied health, home health and hospice, nursing, physicians and advanced practice providers, and non-clinical and administrative roles. With a focus on embracing the values of St. Francis to care for those in need, they provide a supportive and fulfilling work environment for their employees, emphasizing a mission of compassion and community engagement. Franciscan Health is dedicated to offering a variety of employment opportunities across different medical specialties and locations.

📋 Description

• Track and document credentialing and application status changes with participating and non-participating payers • Enter provider data into credentialing databases • Fulfill provider data requests from health plan organizations • Process re-credentialing of established physicians with commercial and managed care plans and complete CAQH attestations • Process provider payer applications, re-applications, and attestations, including mailing, review, and database loading • Submit applications to various payers and follow up on status • Communicate with internal and external customers, including operational and payer calls • Research credentialing-related denials and customer issues • Research payer processes and online payer participation • Compile, review, and submit credentialing and re-credentialing application files to meet federal and state standards

🎯 Requirements

• High School Diploma/GED • 1 year experience in payer enrollment, credentialing, or a related field within a healthcare setting • Strong organizational and multitasking abilities, with keen attention to detail • Excellent communication and interpersonal skills • Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) • Experience with electronic health record (EHR) systems • Familiarity with healthcare regulations and payer policies • Travel required never or rarely

🏖️ Benefits

• Comprehensive benefit offerings for eligible employees