Medical Provider Insurance Credentialing Specialist

1 week ago

Atlanta, United States MD1 Full time
Job DescriptionJob Description

Job Summary:
You will be responsible for managing the credentialing process for MD1 Billing clients. MD1 provides billing services for EMS companies and is expanding into medical billing. This includes preparing, submitting, and tracking applications and renewals, as well as maintaining up-to-date records and ensuring compliance with various regulatory requirements. You will also manage the EDI enrollment process with our clearinghouse and manage the EFT setup with the payers for our clients. Perform eligibility checks for clients. Other duties as assigned by manager.
Key Responsibilities:
1.    Credentialing and Enrollment:
o    Prepare and submit credentialing applications to insurance companies and other third-party payers.
o    Prepare and submit necessary documentation to clearinghouse for EDI enrollment.
o    Prepare and submit information to payers for EFT enrollment.
o    Verify the accuracy and completeness of all provider information.
o    Maintain and update credentialing files with current copies of all required documents.
o    Ensure compliance with all applicable federal, state, and local regulations, as well as the standards of accrediting bodies.
o    Keep abreast of changes in regulations and requirements that affect the credentialing process.
o    Communicate with accounting, operations manager, clients, and client liaison to obtain necessary information and resolve any issues.
o    Serve as a liaison between the healthcare providers and insurance companies.
o    Track the status of applications and re-credentialing processes.
o    Investigate and resolve any discrepancies or issues that arise during the credentialing process.
o    Work to resolve any provider enrollment issues with insurance carriers.
o    Secondary responsibilities will be to assist the Billing team with processing claims for payment.

Qualifications:
1.    Education:
o    High school diploma or equivalent required.
o    Associate’s or Bachelor’s degree in healthcare administration, business, or a related field preferred.
2.    Experience:
o    Previous experience in credentialing or provider enrollment.
o    Experience with medical billing and/or AR is a plus.
3.    Skills:
o    Strong attention to detail and organizational skills.
o    Excellent communication and interpersonal skills.
o    Ability to handle sensitive and confidential information.
o    Proficiency in Microsoft Office Suite and credentialing software.
o    Problem-solving skills and ability to work under pressure.
4.    Certifications:
o    Certification as a credentialing specialist is preferred.
Working Conditions:
•    This position can be remote if location meets HIPAA requirements.
•    Standard business hours, but may require additional hours to meet deadlines.
 

Company DescriptionMD1, Inc. has over nine years of experience billing for EMS and medical services and has become one of the leaders in using technology to provide our clients with real time data to improve their services to communities.

We offer excellent benefits for full time employees, a flexible schedule, continuing education and training, and our people have been with us for years.Company DescriptionMD1, Inc. has over nine years of experience billing for EMS and medical services and has become one of the leaders in using technology to provide our clients with real time data to improve their services to communities. \r
\r
We offer excellent benefits for full time employees, a flexible schedule, continuing education and training, and our people have been with us for years.

  • Credentialing Specialist

    2 months ago

    Atlanta, United States Barbour Orthopaedics Full time

    This is a fully in-office role in our Chamblee location.Job Responsibilities: Process initial credentialing and re-credentialing applications, including verifying healthcare provider information and licensing, conducting background checks, and ensuring that all regulatory requirements are met. Maintain accurate physician and provider privileging files and...

  • Medical Credentialing Liaison and Licensing Specialist

    5 days ago

    Atlanta, United States TeleSpecialists LLC Full time

    Job OverviewWe are seeking a highly skilled Medical Credentialing Liaison and Licensing Specialist to join our team at TeleSpecialists LLC. This is a 100% in-office based position offering a unique opportunity for professional growth and development.

  • Credentialing Verification Specialist

    3 weeks ago

    Atlanta, United States Emory Healthcare Full time

    Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We...

  • Insurance Support Specialist

    6 days ago

    Atlanta, Georgia, United States Bridge Specialty Insurance Brokerage Full time

    Role SummaryWe are seeking an experienced Insurance Support Specialist to join our team at Bridge Specialty Insurance Brokerage in Atlanta, GA.The successful candidate will be responsible for supporting brokers in day-to-day tasks such as reviewing policies, typing quotes & binders and invoicing.About the RoleThis is a full-time on-site opportunity that...

  • Insurance Business Development Specialist

    20 hours ago

    Atlanta, Georgia, United States Right Choice Insurance Services LLC Full time

    Job DescriptionWe are seeking a skilled P&C Insurance Agent to join our team at Right Choice Insurance Services LLC. As an Insurance Business Development Specialist, you will play a vital role in driving business growth and delivering exceptional customer service.Key Responsibilities:Calculate dividends and create payment methods for our clients.Establish...

  • Insurance Verification Specialist

    1 month ago

    Atlanta, United States Ascend Medical, Inc. Full time

    Insurance Verification: Verify patient insurance coverage and eligibility prior to appointments. Confirm coverage details, including copayments, deductibles, and coinsurance. Patient Communication: Communicate with patients about their insurance bene Insurance, Verification, Specialist, Patient Care, Healthcare, Processing

  • Lead Insurance Defense Attorney

    5 days ago

    Atlanta, Georgia, United States Allstate Insurance Full time

    Insurance Defense SpecialistWe are seeking an experienced insurance defense specialist to join our team in Macon, GA. As a key member of our defense team, you will be responsible for conducting depositions and examinations under oath, preparing witnesses and clients for depositions, arbitrations, mediations, and trials.Key Responsibilities:Conduct...

  • Manager, Credentialing

    1 month ago

    Atlanta, United States NextGen Healthcare Full time

    Job Description: The Manager of Credentialing is responsible for managing day-to-day operations and credentialing staff that processes and handles credentialing and re-credentialing applications and other credentialing-related documentation for medical providers. Manages day-to-day operational requirements, ensuring workflow instructions are followed and...

  • Medical Nurse Specialist

    6 days ago

    Atlanta, Georgia, United States All Medical Personnel Full time

    We are seeking a highly skilled Medical Nurse Specialist to join our team at All Medical Personnel.Salary: $ 1500 weekly, paid bi-weekly.Job OverviewThis role will involve providing high-quality patient care in a dynamic and fast-paced environment. As a Medical Nurse Specialist, you will be responsible for collecting specimens from patients, assessing their...

  • Insurance Underwriter Specialist

    3 days ago

    Atlanta, Georgia, United States Right Choice Insurance Services LLC Full time

    Job OverviewRight Choice Insurance Services LLC is seeking an experienced and skilled P&C Insurance Agent to join our team. The ideal candidate will have a strong background in insurance sales, customer service, and risk management.About the RoleThis is a full-time position that involves working with clients to understand their insurance needs, providing...

  • Medical Imaging Specialist

    5 days ago

    Atlanta, Georgia, United States MedPro Healthcare Allied Staffing Full time

    Seeking a qualified Medical Imaging Specialist to join our team at MedPro Healthcare Allied Staffing. This role involves working as a travel Radiology Technician in Atlanta, Georgia.About the PositionType: TravelDuration: 13 weeksShift: 8 hours, eveningsAs a Medical Imaging Specialist, you will be responsible for obtaining useful diagnostic details that help...

  • Medical Imaging Specialist

    13 hours ago

    Atlanta, Georgia, United States MedPro Healthcare Allied Staffing Full time

    Job Title: Medical Imaging SpecialistWe are seeking a highly skilled Medical Imaging Specialist to join our team in Atlanta, GA.About the JobThis is a travel Radiology Technician position that offers a unique opportunity to work in a dynamic healthcare environment. As a Medical Imaging Specialist, you will be responsible for obtaining high-quality diagnostic...

  • Advanced Medical Imaging Specialist

    6 days ago

    Atlanta, Georgia, United States MedPro Healthcare Allied Staffing Full time

    Job Title: Advanced Medical Imaging SpecialistAbout the Job: MedPro Healthcare Allied Staffing is seeking a skilled Advanced Medical Imaging Specialist for a travel assignment in Atlanta, Georgia.Salary and Benefits: The estimated weekly salary for this position ranges from $1,800 to $2,500, depending on experience. Additional benefits include weekly pay,...

  • Medical Ultrasound Specialist

    6 days ago

    Atlanta, Georgia, United States LanceSoft Full time

    About the JobWe are seeking an experienced Diagnostic Imaging Technician to join our team in Atlanta, Georgia. As a Medical Ultrasound Specialist, you will be responsible for conducting ultrasound procedures and providing high-quality patient care.Job Description & RequirementsSpecialty: Ultrasound TechnologistDiscipline: Allied Health ProfessionalStart...

  • Medical Professional

    16 hours ago

    Atlanta, Georgia, United States All Medical Personnel Full time

    Job OverviewWe are seeking a highly skilled and compassionate Medical Professional to join our team as an Outpatient Nursing Specialist in Georgia.About the RoleThis is a fantastic opportunity for a dedicated and experienced nurse to work in a dynamic healthcare setting, providing top-notch care to patients and supporting medical professionals in their daily...

  • Medical Specialist for Cardiac Catheterization

    3 days ago

    Atlanta, Georgia, United States OneStaff Medical Full time

    We are seeking a highly skilled Medical Specialist to join our team in Atlanta, Georgia. This is a 13-week contract position working 40 hours per week, with shifts lasting 10 hours.About the RoleAs a Medical Specialist in Cardiac Catheterization, you will assist doctors performing procedures such as coronary artery catheterization and cardiac ablation. You...

  • Medical Imaging Specialist for Atlanta

    5 days ago

    Atlanta, Georgia, United States MedPro Healthcare Allied Staffing Full time

    We are seeking a skilled Medical Imaging Specialist to join our team in Atlanta, GA. As a Nuclear Medicine Technologist, you will play a crucial role in preparing and administering radiopharmaceuticals and medications to patients.About the RoleThis is a travel assignment with MedPro Healthcare Allied Staffing, one of the leading healthcare staffing agencies...

  • Insurance Certification

    3 weeks ago

    atlanta, United States Focus People Full time

    Position Summary: Our customer is seeking a detail-oriented compliance specialist to support the certification and compliance of Quality Health Plans (QHPs) and Stand-Alone Dental Plans (SADPs) sold through state-managed ACA insurance carriers. Reporting to the Issuer Operations Manager, this role involves policy implementation, compliance monitoring, and...

  • Insurance Certification

    3 weeks ago

    Atlanta, United States Focus People Full time

    Position Summary: Our customer is seeking a detail-oriented compliance specialist to support the certification and compliance of Quality Health Plans (QHPs) and Stand-Alone Dental Plans (SADPs) sold through state-managed ACA insurance carriers. Reporting to the Issuer Operations Manager, this role involves policy implementation, compliance monitoring, and...

  • Insurance Certification

    7 days ago

    Atlanta, United States Focus People Full time

    Position Summary: Our customer is seeking a detail-oriented compliance specialist to support the certification and compliance of Quality Health Plans (QHPs) and Stand-Alone Dental Plans (SADPs) sold through state-managed ACA insurance carriers. Reporting to the Issuer Operations Manager, this role involves policy implementation, compliance monitoring, and...