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CoxHealth Credentialing Specialist

1 month ago

Springfield, United States CoxHealth Full time

Summary

Best in Class Work Environment

  • 5x Modern Healthcare Best Places to work
  • America’s Greatest Workplaces 2023 – Newsweek
  • Greatest Workplace for Women 2023, 2024 – Newsweek
  • Greatest Workplaces for Diversity 2024 – Newsweek
  • Best Employers for New Grads 2023 – Forbes
  • Best Employers by State – Missouri – 2023 – Forbes

Benefits  

  • Robust, fully customizable benefits package including Medical/Vision/Dental and more 
  • No cost eCare visits 
  • Employer-provided mental health services for employees and eligible family members  
  • Retirement with employer match up to 7% 
  • Tuition discounts and reimbursement available for continuing your education 
  • CoxHealth Fitness Center and Child Care discounts 
  • Onsite delivery for CoxHealth Pharmacies and 1906 Employee Store 
Job Summary
  • The Credentialing Specialist is responsible for provider credentialing and re-credentialing of all providers with Medicare and Medicaid. These functions, include, but are not limited to, oversight of affiliate and tertiary credentialing, applying and keeping track of all NPI numbers and update them as needed. The Credentialing Specialist proactively reviews and communicates payor changes/updates. The Credentialing Specialist recognizes when payor updates may require system and or education changes and must communicate with the appropriate individuals. Responsible for identifying and addressing payor variance issues related to reimbursement of services when allowable do not march the contracted rate. Responsible for requesting EFT payments.
Job Requirements
  • Education
    • Required: High School Diploma or Equivalent
    • Preferred: Bachelors in a Related Field
  • Experience
    • Required: 1-2 Years healthcare experience, provider credentialing experience preferred
  • Skills
    • Strong organizational skills
    • Proficient in all Microsoft programs, database experience preferred
    • Ability to communicate effectively with different levels of management
    • Excellent time management, interpersonal, communication, presentation, organization, prioritizing, decision-making, and planning skills.
    • Ability to write effective documentation on processes and procedures.
    • Ability to make routine decisions in accordance with departmental policies and procedures.
  • Licensure/Certification/Registration
    • N/A