Job Description

Nvision Eye Centers Job Opportunity

NVISION Eye Centers is one of the largest ophthalmology providers in the U.S., with over ninety centers across six states including California, Nevada, Oregon, Arizona, Texas, and Utah. An innovative leader in ophthalmology, we are dedicated to providing the best patient experience through the use of the latest technology and treatment by the most talented and experienced surgeons in the industry. With more than 3,000 eye doctors referring their patients and trusting their own eyes to NVISION surgeons, NVISION Eye Centers is the Eye Doctors' #1 Choice.

Responsibilities

• Prepare and submit provider enrollment applications for government payers (Medicare, Medicaid) as well as all contracted medical and vision plans.
• Review initial and reappointment credentialing applications and conduct follow-up, as needed
• Perform primary source verification of all credentialing requirements: education, training, experience, certification and licensing
• Assist with preparation of credentialing packets, participate and assist in facilitating credentialing committee meetings
• Communicate appointment, reappointment, clinical privileging decisions and changes to providers and internal/external parties, as required
• Access external databases to obtain required documents necessary to complete credentialing applications
• Manage validation of provider rosters for accuracy, as required by contracted payers
• Recurring review and validation of provider directory listing(s) and follow-up with health/vision plans to ensure submissions have been accurately processed
• Maintain provider state licenses, DEA certificates, board certifications, malpractice insurance and any other expirable documents
• Populate, maintain and update credentialing database to ensure accountability for the integrity of the information entered in the system.
• Respond to requests/inquiries from health plans, as well as other departments
• Perform research of state licensing and credentialing requirements in California and other regions
• Perform general administrative tasks and assist with special projects, as needed
• Assist with special projects, as needed

Qualifications

• Knowledge and understanding of the credentialing and provider enrollment processes
• Experience with managing/maintaining provider directory information within a managed care setting
• Knowledge and understanding of credentialing process, federal and state regulatory requirements and accreditation standards
• Ability to work independently with minimal supervision
• Must have strong organizational and time management skills
• Ability to work on multiple projects and meet deadlines
• Excellent communication and relationship building skills
• Detail oriented
• Understanding of medical terminology
• Be a team player

Education and Experience:

• High school diploma required; Associate or Bachelor's degree preferred
• 3+ years' experience with provider enrollment, credentialing and primary source verification
• Credentialing experience within a managed care setting preferred
• Experience with MD Staff credentialing software preferred
• Experience with SmartSheet preferred
• Proficient in Microsoft Word and Excel
• CPCS and/or CPMSM preferred

*This role will be based out of Aliso Viejo, but is eligible for a "hybrid" (office and remote) work schedule*

Min

USD $25.00/Hr.

Max

USD $28.00/Hr.

Job Tags

Similar Jobs