Credentialing Specialist

4 weeks ago

Logan, United States Oracle Full time
Job DescriptionJob Description

Credentialing Specialist

Oracle BCC is currently seeking a proficient, and detail-oriented Credentialing Specialist. Oracle BCC provides healthcare administration services for individual providers and organizations. This is a full-time work-from-home position working Monday-Friday during regular business hours. Your normal place of work is your home office however the employer may require you to work at other locations temporarily as we may from time to time require.

The Credentialing Specialist is an important part of the Oracle BCC team.The Credentialing Specialist is responsible for maintaining active status for all providers by completing initial and subsequent credentialing as required by commercial payers, Medicare, and Medicaid.

Oracle BCC operates within the Aegis family of companies across the healthcare industry operating in 3 states. Additionally, Oracle BCC contracts services to companies across the United States and is continuing to grow. There is an abundance of opportunities for professional development and growth.

Benefits

  • Comprehensive Medical Plan
  • Dental Plan
  • Vision Plan
  • Wellness Program
  • 401 (k) Retirement Savings Plan
  • Life, Accident, & Disability Insurance
  • Paid Sick Leave
  • Paid Holidays
  • Aegis Experience Rewards Program

Being the Difference

We are looking for employees with the following qualities:

  • Thrive on establishing high level standards
  • Committed to professionalism while performing job duties and responsibilities
  • Positive attitude
  • Team player
  • Proactive problem solver
  • Honesty and integrity

If you would like to be a part of an outstanding team that supports world-class providers, we look forward to hearing from you.


Credentialing Specialist Job Responsibilities:

  • Maintain individual provider files through OneDrive to include up-to-date information needed to complete the required governmental and commercial payer credentialing applications
  • Maintain internal provider spreadsheets for each agency to ensure all information is accurate and logins are available
  • Update each provider's CAQH database file timely according to the schedule published by CMS
  • Complete revalidation requests issued by government payers
  • Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid
  • Complete re-credentialing applications for payers
  • Work closely with the billing staff to identify and resolve any denials or authorization issues related to provider credentialing
  • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
  • Other duties as assigned

Skills & Qualifications:

  • Minimum of 2 years experience in credentialing including commercial, Medicaid and Medicare
  • Skill in computer applications, Windows 10, Office 365, Excel, Word, Outlook.
  • Knowledge of provider credentialing and its direct impact on the practice's revenue cycle
  • Detail oriented with above average organizational skills
  • Plans and prioritizes to meet deadlines
  • Excellent customer service skills; communicates clearly and effectively Ability to learn new software quickly.
  • Experience with electronic health records.
  • Requires excellent keyboarding skills.
  • Must be at least 18 years of age

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