Medical Credentialing Specialist

1 week ago

Fort Worth, United States Arlington Orthopedic Association Full time
Job DescriptionJob DescriptionDescription:

JOB SUMMARY: Responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical providers who provide patient care for Arlington Orthopedic Associates, P.A. (AOA). Responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities. Maintain current accurate data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications; maintain and provide reference tool(s) of current insurance network status for all AOA medical providers to all personnel involved in patient intake, scheduling, precertification, billing and collection processes.


*RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:*

  • Compiles and maintains current and accurate data for all AOA medical providers.
  • Completes provider credentialing and re-credentialing applications; monitors applications and follows up accordingly with facility and/or insurance to ensure prompt completion.
  • Keeps medical provider(s) and direct manager aware of current state of credentialing and re-credentialing application status via e-mails, provider meetings, staff meetings.
  • Maintains copies of current stat licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all AOA medical providers.
  • Sets up and maintains current accurate provider information using Council for Affordable Quality Healthcare (CAQH) and other online credentialing databases; keeps AOA credentialing software current at all times.
  • Tracks license, DEA, professional liability, health records, and other certification expirations for AOA medical providers to ensure timely renewals.
  • Ensures practice addresses are current with health plans, agencies and other entities.
  • Processes applications for appointment and reappointment of privileges at various medical facilities.
  • Audits health plan online directories for current and accurate provider information.
  • Keeps knowledgeable of current health plan requirements for credentialing AOA providers.
  • Maintains company files with current insurance contracts/addendums, fee schedules and examples of health plan member card(s).
  • Provides and maintains current reference tool(s) relative to AOA medical providers’ insurance network status for all personnel involved in patient calls, patient intake, scheduling, precertification, billing and collection processes.
  • Sends company-wide announcement e-mail regarding new insurance information, updated insurance information, provider credentialing updates, copies of new/updated member insurance card(s).
  • Maintains company files with medical provider credentialing documents in secured location.
  • Maintains work area in neat and orderly manner at all times.
  • Attends regular staff meetings as requested.
  • Maintains strict confidentiality of provider data.
  • Performs other duties as assigned by manager.
Requirements:

EDUCATIONAL REQUIREMENTS:

  • High School Diploma/GED or equivalent experience.
  • Associate degree preferred

QUALIFICATIONS AND EXPERIENCE

  • Certified Provider Credentialing Specialist (CPCS) preferred.
  • Must have 2 years of relevant credentialing experience (insurance and facility)
  • Working knowledge and understanding of the credentialing process (insurance and facility).
  • Excellent verbal and written communication skills.
  • Professional demeanor at all times with all medical and non-medical personnel.
  • Detail oriented ensuring all steps in credentialing process are completed timely.
  • Ability to research and analyze data.
  • Ability to work independently with minimal supervision.
  • Ability to work efficiently to meet credentialing deadlines.
  • Ability to establish and maintain effective working relationships with providers, management, staff, insurance contacts, and other contacts outside of organization.

  • Credentialing Specialist

    4 weeks ago

    Fort Worth, United States Serenity Healthcare Full time

    Job DescriptionJob DescriptionCredentialing Specialist**Not Remote** Onsite Only - Fort Worth, TXSerenity Healthcare is seeking a Credentialing Specialist to join our team at our corporate office in Fort Worth, TX. This person will work closely with providers and medical office staff. You will be responsible for ensuring that our newly hired and established...

  • Credentialing Specialist

    2 weeks ago

    Fort Worth, United States Serenity Healthcare Full time

    Job DescriptionJob DescriptionCredentialing Specialist**Not Remote** Onsite Only - Fort Worth, TXSerenity Healthcare is seeking a Credentialing Specialist to join our team at our corporate office in Fort Worth, TX. This person will work closely with providers and medical office staff. You will be responsible for ensuring that our newly hired and established...

  • Credentialing Specialist

    2 days ago

    Fort Worth, United States Serenity Healthcare Full time

    Job DescriptionJob DescriptionCredentialing Specialist**Not Remote** Onsite Only - Fort Worth, TXSerenity Healthcare is seeking a Credentialing Specialist to join our team at our corporate office in Fort Worth, TX. This person will work closely with providers and medical office staff. You will be responsible for ensuring that our newly hired and established...

  • Credentials Specialist

    2 months ago

    Fort Lauderdale, United States Broward Health Full time

    Coordinates the initial credentialing, privileging, and annual/bi-annual reappointment of the medical staff and allied health professional to ensure that only qualified practitioners provide care in the hospital and ambulatory care settings in accord Specialist, Healthcare, Health

  • Credentialing Specialist

    4 weeks ago

    Fort Collins, United States SummitStone Health Partners Full time

    Job DescriptionJob DescriptionOverviewA Facility Credentialing & Licensing Specialist needed to help us in our endeavor to build the healthiest community in the nation … one person at a time.The Mission: At SummitStone Health Partners, we strive to foster trust, empower recovery, and inspire hope to strengthen and enrich our Northern Colorado community.We...

  • Credentialing Specialist

    4 days ago

    Fort Lauderdale, United States Hayes Locums Full time

    Overview & Benefits:The Credentialing Specialist is responsible for data entering, gathering, and primary source verification of healthcare practitioner information, including in-depth, detailed, or challenging research of information. Primary methods of researching information include phone, fax, e-mail, and letters.Office Hours: M-F 9AM-6PMHybrid policy:...

  • Facility Credentialing Specialist

    4 weeks ago

    Fort Collins, United States SummitStone Health Partners Full time

    Job DescriptionJob DescriptionOverviewA Facility Credentialing & Licensing Specialist needed to help us in our endeavor to build the healthiest community in the nation … one person at a time.The Mission: At SummitStone Health Partners, we strive to foster trust, empower recovery, and inspire hope to strengthen and enrich our Northern Colorado community.We...

  • Credentialing Specialist

    4 weeks ago

    Fort Lauderdale, United States GiaCare Full time

    JOB SUMMARY: This is a highly interactive position that requires the ability to work independently and with a team in a time sensitive environment. This position requires an employee that is organized and capable of juggling multiple projects at one time. The Credentialing Specialist will be responsible for all aspects of contract assignment, credentialing,...

  • Internal Credentialing Specialist

    10 hours ago

    Fort Lauderdale, United States Hayes Locums Full time

    The Internal Credentialing Specialist will be part of our Internal Credentialing department working closely with the sales team and our risk department. The Internal Credentialing Team provides white glove customer service to our physicians, advanced practitioners, and internal staff by processing Hayes Locums credentialing files. Your personal drive for...

  • Credentialing Specialist

    4 weeks ago

    Fort Lauderdale, United States Giacare Inc Full time

    Job DescriptionJob DescriptionJOB SUMMARY: This is a highly interactive position that requires the ability to work independently and with a team in a time sensitive environment. This position requires an employee that is organized and capable of juggling multiple projects at one time. The Credentialing Specialist will be responsible for all aspects of...

  • Credentialing Specialist I

    4 weeks ago

    Fort Myers, United States TeleSpecialists LLC Full time

    Job DescriptionJob DescriptionThis position is 100% office based in either our Ft. Myers Fl or Atlanta Ga officesCredentialing Specialist IAbout Us: TeleSpecialists is a rapidly growing national telemedicine company seeking the right talent to join our team. We provide emergent and routine neurology and psychiatry services in over 300 hospitals across the...

  • Credentialing Specialist I

    2 months ago

    Fort Myers, United States TeleSpecialists LLC Full time

    Job DescriptionJob DescriptionThis position is 100% office based in either our Ft. Myers Fl or Atlanta Ga officesCredentialing Specialist IAbout Us: TeleSpecialists is a rapidly growing national telemedicine company seeking the right talent to join our team. We provide emergent and routine neurology and psychiatry services in over 300 hospitals across the...

  • Credentialing Specialist I

    2 days ago

    Fort Myers, United States TeleSpecialists LLC Full time

    Job DescriptionJob DescriptionThis position is 100% office based in either our Ft. Myers Fl or Atlanta Ga officesCredentialing Specialist IAbout Us: TeleSpecialists is a rapidly growing national telemedicine company seeking the right talent to join our team. We provide emergent and routine neurology and psychiatry services in over 300 hospitals across the...

  • Patient Service Specialist

    4 days ago

    Fort Worth, United States Select Medical Full time

    Looking for a customer service, detail oriented individual who is able to work in a fast paced environment. Tasks include check in, check out, insurance verifications, scheduling, reports, faxing and scanning and other office duties. To provide outst Medical, Patient, Specialist, Customer Service, Office, Service, Healthcare

  • Patient Service Specialist

    3 days ago

    Fort Worth, United States Select Medical Full time

    Overview Baylor Scott & White Institute for Rehabilitation Location: Fort Worth, TX (Fort Worth Day Neuro) Patient Service Specialist (PSS) Hours: vary between Monday - Friday 8am - 5pm Full Time Compensation depends upon candidate's years of experience and internal equity. This is an entry-level position. Starting salary: $18 per hour based off...

  • Medical Claims Specialist

    4 weeks ago

    Fort Worth, United States Serenity Healthcare, LLC Full time

    Medical Claims Specialist - Full-time *Onsite - Fort Worth, TXSerenity Healthcare is seeking a Medical Claims Specialist to provide the billing team with additional support in order to obtain financial compensation for medical claims. The claims specialist reviews unpaid medical claims and makes requests to insurance companies for payment.Daily...

  • Medical Sales Specialist

    2 weeks ago

    Fort Worth, United States TalentWell Full time

    Medical Sales Specialist Opportunity:TalentWell is hiring a Medical Sales Specialist for a permanent position supporting a rapidly growing, Texas-based, clinical laboratory company. This position will support the Fort Worth/Lubbock/Amarillo territory. This company has received various awards including USA Today's Top Work Places 2024, Culture Excellence...

  • Medical Sales Specialist

    4 weeks ago

    Fort Worth, United States TalentWell Full time

    Medical Sales Specialist Opportunity:TalentWell is hiring a Medical Sales Specialist for a permanent position supporting a rapidly growing, Texas-based, clinical laboratory company. This position will support the Fort Worth/Lubbock/Amarillo territory. This company has received various awards including USA Today's Top Work Places 2024, Culture Excellence...

  • Medical Sales Specialist

    4 weeks ago

    Fort Worth, United States TalentWell Full time

    Medical Sales Specialist Opportunity:TalentWell is hiring a Medical Sales Specialist for a permanent position supporting a rapidly growing, Texas-based, clinical laboratory company. This position will support the Fort Worth/Lubbock/Amarillo territory. This company has received various awards including USA Today's Top Work Places 2024, Culture Excellence...

  • Medical Sales Specialist

    2 weeks ago

    Fort Worth, United States TalentWell Full time

    Medical Sales Specialist Opportunity:TalentWell is hiring a Medical Sales Specialist for a permanent position supporting a rapidly growing, Texas-based, clinical laboratory company. This position will support the Fort Worth/Lubbock/Amarillo territory. This company has received various awards including USA Today's Top Work Places 2024, Culture Excellence...