Healthcare Credentialing Specialist

2 weeks ago

Lewes, Delaware, United States Beebe Healthcare Full time
Why Beebe Healthcare?

Beebe Healthcare is a vibrant and inclusive team positioned in a coastal community, offering a fulfilling career that supports the health of our patients and a team focused on excellence.

Benefits
  • Competitive compensation and wellness benefits (medical, dental, vision, and prescription)
  • Sign-on and Referral Bonuses for select positions
  • Tuition Assistance up to $5,000
  • Paid Time Off
  • Long Term Sick accrual
  • Employer Contribution Plan
  • Free Short and Long-Term Disability for Full Time employees
  • Zero copay for drugs on prescription plan for certain conditions
  • College Bound 529 Savings Plan
  • Life Insurance
  • Beebe Perks via Work Advantage
  • Employee Assistance Program
  • Pet Insurance
Overview

The Credentialing Specialist is responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities as needed. This role maintains up-to-date data for each provider in various credentialing databases/systems and ensures timely renewal of all licensure and certification requirements for insurance purposes.

Responsibilities
  • Must be current with knowledge of online credentialing databases and systems
  • Extremely organized and detail-oriented in maintaining accurate provider records of all required licensure, professional liability, practice locations, and any and all other verifications requested
  • Maintains current knowledge of accrediting body standards
  • Maintains confidentiality of provider and Group's information and documentation
  • Familiarity with medical billing and claims payment system requirements as it relates to provider enrollment and the provider credentialing process
  • Maintains open communication with CBO Manager and Group's contractual payors
  • Maintains current knowledge of insurance payer base provider requirements and assures compliance with all regulatory requirements
  • Maintains open communication with medical credentialing staff at Beebe Healthcare
Qualifications
  • Minimum 2 years experience in a healthcare office setting
  • Proficiency in the use of online credentialing databases and systems, i.e. NPI, PECOS, CAQH; Microsoft Office Applications (Word, Excel) and internet resources
  • Prior experience with medical billing and claims payment system requirements as it relates to provider enrollment
  • Ability to obtain Certified Provider Credentialing Specialist (CPCS) within two years
Credentials

Experience with medical provider credentialing process, policies, and procedures, including delegated credentialing requirements; familiarity with medical billing and claims payment system requirements as it relates to provider enrollment; demonstrated ability to work independently, with strong written and oral communication skills to effectively correspond with all levels of personnel and physicians/providers.

Education

Starting at: USD $24.14/Hr.

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