Medical Credentialing Specialist
2 weeks ago
NO REMOTE WORK-Position is on site on Wayne, NJ Mon thru Fri. Working hours are 9am-5:30pm
Qualifications:
· Credentialing Experience and process preferred for managed care companies, hospitals and surgical centers
· Medical practice experience required
· Ability to organize and multitask efficiently
· Excellent verbal and written communication skills
· Ability to professionally adapt to a rapidly changing environment
· Positive attitude towards continuous training
· Ability to work independently as well as in a team environment
· Ability to establish and maintain positive and effective work relationships with coworkers and providers
· CAQH knowledge is preferred but not required
· Microsoft Office Experience (Excel, Outlook, Word)
· Must be able to work and 8-hour shift in office
Responsibilities:
· Complete enrollment/credentialing and re-credentialing applications
· Maintain a detailed log of all pending and completed work
· Communicate the results of status of the applications to manager, physicians and coworkers
· Maintenance of physician enrollment and CAQH profiles
· Documentation within enrollment database
· Coordinate Signatures with manager for providers
· Daily call to insurances for credentialing status
· Research and resolve claim denials due to credentialing issues
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