Credentialing Specialist

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Job Title :

Credentialing Specialist

Department :

University Hospital Credentialing Services

Position Summary :

The Credentialing Specialist will be responsible for all activities related to enrollment of providers for government payors and assuring continued enrollment.

Supporting the maintenance of provider demographics (practicing addresses, billing addresses, NPI, Medicare / Medicaid numbers) to support delegated credentialing with payers and the accountable care organization (ACO).

The primary responsibility will be initiating and monitoring the provider corporate credentialing functions to assure that all practitioners and all clinical billing organizations are enrolled in all required and government payor programs in accordance with established thresholds (Medicare, Medicaid, Bureau of Worker’s Compensation, etc.

and enrollment into other both delegated and non-delegated health plans. Credentialing specialists may also be asked to work on special projects required for ongoing business relationships and strategic initiatives.

Position requires excellent written and verbal communication skills and the ability to work independently, while managing multiple priorities to ensure proper claims payment and no loss of revenue.

Minimum Qualifications :

Bachelor’s degree (preferably in healthcare field) and two years’ experience in a hospital setting and / or managed care setting with demonstrated experience in enrollment functions, or equivalent combination of education and experience.

Our Comprehensive Employee Benefits Include :

An array of retirement plan options, each with a generous employer contribution.

Affordable health insurance options, including dental, vision and prescription coverage that begin on day one.

Paid vacation and sick leave, including short and long-term disability and paid parental leave.

Get the most out of the Public Service Loan Forgiveness program.

And much more!

Explore our extensive benefits

Work-life : Flexible and remote work arrangement opportunities where applicable, childcare program, and access to educational, athletic and cultural events.

Retirement : State pension and alternative options with competitive employer contributions, as well as optional supplemental plans.

Health : Medical, dental, vision and prescription coverage, life insurance, flexible spending accounts and wellness programming.

Time off : Paid vacation and sick time, parental and medical leave plus 11 paid holidays. Short and long-term disability options also available.

Financial : Tuition assistance for employees and their dependents, adoption assistance and discounts with preferred vendors and university partners.

Wellness : Lifestyle spending account, employee assistance program, health reimbursement account, and employee wellness program.