Enrollment and Credentialing Specialist

4 weeks ago

Dallas, United States Sonic Healthcare USA Full time

Quality is in our DNA -- is it in yours?


You are a superhero when it comes to patient specimens. You’ve got problem-solving instincts, a passion for patient care, and the drive to keep things running smoothly. You’re also looking for great benefits, the support of an all-star team, and an opportunity to grow your career.


Join our front line of #HealthcareHeroes Our mission is to advance the health and wellbeing of our communities as a leader in clinical laboratory solutions.


Location: Dallas, Texas - ON-SITE (this is not a remote opportunity)

Full-time: Benefit Eligible

Days: Monday - Friday

Hours: 8:00 AM - 5:00 PM


In this role, you will:


The Provider Enrollment & Credentialing Representative will be accountable for the initiation of new credential files, ensuring the completeness of a new application as the first step in the credential's verification process, and participating in verification of credentials through correspondence, phone contact, internet sites and any other third-party vendor.

  • Initial credentialing and re-credentialing of physicians.
  • Obtains Medical Licenses as required, as well as ensures that all medical staff meet and maintain active licensure.
  • Oversee the maintenance of all certifications required to successfully license and credential all physicians with the exception of the laboratory’s CLIA licenses.
  • Coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
  • Conducts thorough background investigation, research and primary source verification of all components of the application file.
  • Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
  • Prepares credentials file for completion and presentation to Entity Credentialing Committees, ensuring file completion within time periods specified.
  • Responsible for CAQH files for providers to ensure completion and maintain revisions/updates.
  • Processes requests for Provider Enrollment ensuring compliance with criteria outlined in descriptions for both commercial and Government payers.

​

All you need is:

  • Bachelor’s Degree or the equivalent years of experience.
  • Prior years of related experience; or equivalent combination of education and experience.
  • Ability to solve complex problems to support the planning, organizing, and coordinating of provider payer credentialing.
  • Knowledge of medical terminology, insurance billing, credentialing and licensing processes as demonstrated by work experience and education.


Company:

Sonic Anatomic Pathology


We’ll give you:

  • Appreciation for your work
  • A feeling of satisfaction that you’ve helped people
  • Opportunity to grow in your profession
  • Free lab services for you and your dependents
  • Work-life balance, including Paid Time Off and Paid Holidays
  • Competitive benefits including medical, dental, and vision insurance
  • Help saving for retirement, with a 401(k) plus a company match
  • A sense of belonging – we’re a community

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