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Medicaid Credential Specialist
4 months ago
Location: Springfield IL
Duration: Full time
Salary: USD 35k to 50k
Description:
The primary functionality of this role includes Verification of provider credentials through various government agencies and license boards, reviewing the accuracy of provider demographic and billing information within the States system, and various data entry functions.
Research, verify, and document provider credentialing information through various government agencies and license boards as part of provider enrollment regulations.
Document communication notes and resolution outcomes
Review the application and update submission in its entirety and confirm that all data is accurate, and all revalidation documents are completed and uploaded, ensuring that all verification documents are complete.
Requirements:
- 3 Years in similar role, vast understanding of Medicaid and Provider enrollment
- Knowledge of Medicaid provider credentialing standards and requirements
- Assist Medicaid Providers on the processes, policies, and procedures within the State.
- Track record of accomplishments and ability to document communication and outcomes effectively
- Excellent organizational, communication and interpersonal skills
- Strong customer service experience, preferably in a provider services call center or credentialing department
- Strong oral and written skills with the ability to participate in webinars and seminars. Ability to effectively interact with leadership.
- Work with State Management Staff daily to ensure that all Medicaid providers' applications have been submitted and approved.
- Ability to perform comfortably in a fast-paced, deadline-oriented work environment
- Proficient in Microsoft Office (PowerPoint, Word, Excel and Outlook)
- Ability to work as a team member as well as independently
- Ability to successfully execute many complex tasks simultaneously
- Experience in a health care environment Understanding of provider billing practices and claim processing is preferred
- Physical Requirements must be able to remain in a stationary position for an extended period.
Bachelor's degree in business administration, Public Administration, OR equivalent workplace experience equivalent to four (4) years of college.
