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Visionworks Credentialing Specialist
2 months ago
We are seeking a highly skilled Credentialing and Re-credentialing Specialist to join our team at Visionworks. As a key member of our organization, you will be responsible for ensuring the credentialing and re-credentialing status of retail stores and doctors is up-to-date and accurate.
Key Responsibilities- Monitor and maintain the credentialing and re-credentialing status of retail stores and doctors to ensure timely activation.
- Research and resolve unpaid claims related to credentialing issues.
- Maintain accurate and up-to-date MVC website data for all locations.
- Enroll new locations and doctors for EDI claim submission.
- Manage Network Management related research projects as needed.
- High School Diploma, GED, or equivalent work experience.
- Three (3) plus years of related experience.
- Proficient Microsoft Excel, Word, and Access skills.
- Working knowledge of the Insurance Industry.
- Excellent communication and organizational skills.
The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the associate is required to stand, use hands and fingers to handle, feel, pick or pinch, and talk or hear most of the time. The associate is occasionally required to stand, walk, and reach with hands and arms. The associate must frequently lift and/or move up to 20 pounds.
Behavioral Characteristics- Multi-task orientated.
- Exhibit empathy and good phone resolution skills.
- Strong customer service focus and commitment.
- Well-developed interpersonal skills.
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.
As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times.
As a result, Associates must explicitly adhere to all data security guidelines established within the Company's Privacy & Security Training Program.
