Credentialing Specialist

3 weeks ago

Portage, United States Ascend Practice Management Full time

**Credentialing and Contracting Specialist**

**Overview**:
**Educational Requirements**:

- High School Diploma or G.E.D.

**Experience Required**:
Minimum of 3 years non-clinical medical office experience with the skills below:
**Areas of Responsibilities**:
1. _**Credentialing**:_
- Manage the end-to-end credentialing process for healthcare providers, including physicians, nurses, and allied health professionals.
- Collaborate with providers to gather necessary documentation and information for credentialing purposes.
- Conduct thorough verification of professional licenses, certifications, and relevant credentials.
- Track and monitor credentialing status, ensuring ongoing compliance with organizational and regulatory requirements.

2. _**Contracting**:_
- Facilitate contract agreements with insurance providers, payers, and managed care organizations.
- Collaborate with legal and compliance teams to review and finalize contractual documents.
- Ensure that contract terms align with organizational goals and industry standards.
- Maintain updated knowledge of healthcare regulations and reimbursement policies to inform contract negotiations.
- Monitor and manage contract renewal processes, ensuring timely updates and renegotiations when necessary.

3. _**Database Management**:_
- Maintain accurate and up-to-date provider information in the credentialing and contracting databases.
- Develop and implement efficient data management processes to streamline credentialing and contracting workflows.
- Generate reports and analytics related to credentialing and contracting activities.

4. _**Compliance and Quality Assurance**:_
- Stay informed about industry changes and updates related to credentialing and contracting.
- Conduct internal audits to ensure compliance with accreditation standards and regulatory requirements.
- Collaborate with internal stakeholders to address and resolve any compliance issues.

**Qualifications**:

- Proven experience in credentialing and contracting within the healthcare industry.
- Strong understanding of healthcare regulations, accreditation standards, and reimbursement policies.
- Excellent negotiation, communication, and interpersonal skills.
- Detail-oriented with exceptional organizational and time-management abilities.
- Proficient in using credentialing and contracting software and databases.

**Benefits**:

- Competitive salary
- Employer Paid Healthcare Reimbursement Program (QSEHRA)
- Tuition Reimbursment
- Employer Paid Life and AD&D Insurance Policy
- Flexible Paid Time Off
- Professional development opportunities
- Positive and collaborative work environment

Pay: $18.00 - $22.00 per hour

Expected hours: 40 per week

**Benefits**:

- AD&D insurance
- Flexible schedule
- Flexible spending account
- Life insurance
- Paid time off
- Tuition reimbursement

Schedule:

- Monday to Friday

**Experience**:

- Credentialing & Contracting: 3 years (required)

Work Location: Hybrid remote in Portage, IN

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