Credentialing and Licensure Specialist
4 days ago
At Paradigm Oral Health, we are seeking a highly skilled Credentialing & Licensure Specialist to join our team. This role is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, and commercial payers.
Key Responsibilities:- Maintain compliance with all regulatory and accrediting institutions.
- Manage individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
- Maintain CE hours to ensure compliance with state regulations.
- Apply for and renew all provider licenses.
- Complete revalidation requests issued by government payers.
- Complete credentialing applications to add providers to commercial payers and re-credentialing applications for commercial payers.
- Partner with Clear Choice to ensure credentialing of new providers and re-credentialing current providers.
- Maintain provider credentials with hospitals at which they hold staff privileges.
- Facilitate Integration of Acquisition and required processes.
- Work closely with the Revenue Cycle team to identify and resolve any denials or authorization issues related to provider credentialing.
- High School Diploma or equivalent required.
- Associates degree in related field preferred.
- Two or more years of relevant experience required.
- Credentialing experience preferred.
- Competitive pay and bonus potential.
- 401(k) Plan with Company Match.
- Health Savings Account (HSA) with HDHP health plans.
- Basic and Supplemental Life Insurance.
- Spouse and Child Life Insurance.
- Paid Vacation and 6 Annual Paid Holidays.
- Long and Short Term Disability Plans.
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