Medical Device Credentialing Professional
3 weeks ago
Overview:
Oticon Medical, a leading Hearing Implant company, is seeking a skilled Credentialing Specialist to join our Insurance Team. As a key member of our team, you will play a crucial role in improving access to our life-changing technologies.
Responsibilities:
- Obtain necessary data from providers to initiate the credentialing process.
- Perform quality review audits of credentialing files to ensure compliance with internal policies and procedures, as well as local and federal regulatory requirements.
- Maintain up-to-date data for sales territories and track Oticon Medical's licenses, certifications, and professional liability insurances to ensure timely renewals.
- Coordinate with the insurance and field teams to stay ahead of pertinent insurances and interact with internal departments and varied levels of management to accomplish credentialing timelines.
- Meet or exceed departmental timeframes and quality metrics on a consistent basis.
- Perform all other related duties as assigned.
Qualifications:
- 3+ years of experience in a credentialing role, preferably in DME, Audiology, or Medical device background.
- Ability to develop and manage credentialing independently, with a willingness to learn, take initiative, and be resourceful.
- A bias for action and pragmatic solutions, with detail and results-oriented skills to manage and prioritize requests effectively.
- The ability to be flexible in an ambiguous and dynamic environment, solve problems, and establish trust.
- Demonstrated skills in problem-solving, analysis, and resolution, with the ability to function independently and possess flexibility in multiple project management capabilities.
- Compliance with HIPAA rules and regulations, as well as extensive knowledge of state licensing requirements, primary source verifications, and credentialing database maintenance.
- Working knowledge of payer credentialing rules, portals, and regulations is preferred, and CPCS Certification is a plus.
Oticon Medical is an Equal Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.
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