Job Description

Credentialing Specialist

Job Category: HOPCo

Requisition Number: CREDE009844

Full-Time

Corporate Office Phoenix, AZ 85023, USA

Description

Remote position!! Benefits:

• Competitive Health & Welfare Benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match (Part-time employees included)
• Employee Assistance Program that is available 24/7 to provide support
• Employee Appreciation Days
• Employee Wellness Events

Minimum Qualifications:

• Minimum of 2 years of credentialing experience.
• High school diploma/GED or equivalent working knowledge preferred.
• Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors, and the public
• Must be capable of establishing good working relationships with both internal and external customers.
• Some knowledge of insurance billing and hospital credentialing is a plus.

Essential Functions:

• Reviews and completes hospital and payor applications for all health care providers.
• Completes verification forms/letters for outside facilities.
• Maintain billing insurance grid, provider insurance grid, and each physician's spreadsheet up to date on current insurance changes.
• Track and maintain physician licensure(s), certification, and CME credits.
• Maintain practitioner credentialing files.
• Maintain practitioner electronic file by keeping all applications/licensure current.
• Maintains all renewal applications for both hospitals/insurances.
• Has knowledge of Employee Handbook content along with established policies and procedures.
• Relies on instructions and pre-established guidelines to perform the functions of the job.
• Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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