Payer Credentialing Specialist

External Description

Payer Credentialing Specialist

Are you looking for an opportunity to advance your career while working with an extraordinary team? At Merakey, we put heart and soul into everything we do.

We are seeking a full-time Payer Credentialing Specialist to join our Business Operations team in Pennsylvania.

Earn $

Position Details

The Payer Credentialing Specialist will manage all aspects of staff payer credentialing across Merakey. This position will serve as the point of contact for facility and practitioner credentialing and re-credentialing needs.

This position will report directly to the Director of Contracts and Credentialing.

Duties and Responsibilities :

• Develop and maintain relationships with practitioners, site and program directors along with the provider support specialists at the various payer sources.
• Ensure that appropriately completed credentialing and re-credentialing applications are submitted to every contracted payer for each Merakey employed or contracted Physician, Practitioner, other licensed providers (NP, Physician Assistant, Psychologist, LCSW, LPC, etc) in timely fashion.
• Ensure and maintain active Medicare and Medicaid enrollments for all qualified Physicians, Practitioners, other licensed providers.
• Respond timely to all written, verbal, and electronic payer requests regarding missing or additional information necessary to complete the credentialing / re-credentialing process for each Physician, Practitioner, other licensed provider.
• Maintain the accuracy of Physician / Practitioner payer credentialing records in CAQH, PROMISe, PECOS, (credentialing software), and other formats accepted by contracted payers.
• Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all.
• Provide periodic updates with regard to credentialing status of any new Physician / Practitioner.
• Research and respond to all inquiries from Merakey sites and CBO staff related to claims denied for provider not credentialed and other related set-up issues.
• Assist with special projects as assigned by supervisor.
• Participate in Activities Management meetings / calls as requested or assigned.
• This position may require minimal travel, 0-10% between Administration Buildings.

Benefits

Merakey offers medical, dental - vision insurance plans, competitive compensation plans and more!

• DailyPay
• Work / Life Balance
• Flexible Schedules
• Cell Phone Discount Plans
• Employee Referral Bonuses
• Tuition Reimbursement
• Membership

About Merakey

Merakey is a non-profit provider of developmental, behavioral health, and education services. More than 8,000 employees provide support to nearly 40,000 individuals and families throughout 12 states across the country each year.

Merakey strictly follows a zero-tolerance policy for abuse.

Merakey is proud to be an Equal Opportunity Employer! We deeply value diversity and do not discriminate on the basis of race, religion, color, national origin, ethnic background, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or disability status.

Moreover, we are committed to creating teams that reflect the diversity of the communities we serve and encourage applicants from underrepresented backgrounds to apply.

Merakey welcomes all Veterans to apply!

Requirements

Our ideal candidate will possess the following skills :

• At least 2 years credentialing experience working with CAQH, Provider Enrollment, etc.
• Proficient in Microsoft Word, Excel, and Outlook
• Ability to work independently and within a group, with minimal daily supervision
• Strong analytical and problem solving skills.
• Excellent writing and verbal communication skills.
• Degree preferred
16 days ago