CREDENTIALING & LICENSURE SPECIALIST
Company: Paradigm Oral Health
Location: Cortland
Posted on: October 14, 2024
Job Description:
Role and Responsibilities The Credentialing & Licensure
Specialist is responsible for maintaining active status for all
providers by successfully completing initial and subsequent
credentialing packages as required by hospitals, surgery centers,
and commercial payers. Roles and Responsibilities
- Maintains compliance with all regulatory and accrediting
institutions.
- Manages individual provider files to include up to date
information needed to complete the required governmental and
commercial payer credentialing applications.
- Maintains CE hours to ensure compliance with state
regulations.
- Applies for and renews all provider licenses.
- Completes revalidation requests issued by government
payers.
- Completes credentialing applications to add providers to
commercial payers and re-credentialing applications for commercial
payers.
- Partners with Clear Choice to ensure credentialing of new
providers and re-credentialing current providers.
- Maintains provider credentials with hospitals at which they
hold staff privileges.
- Facilitates Integration of Acquisition and required
processes.
- Works closely with the Revenue Cycle team to identify and
resolve any denials or authorization issues related to provider
credentialing.
- Performs other duties as assigned.Education and Experience
- High School Diploma or equivalent required.
- Associates degree in related field preferred.
- Two or more years of relevant experience required.
- Credentialing experience preferred. Skills and Abilities
- Knowledge of provider credentialing.
- Excellent computer skills including Excel, Word, and Internet
use.
- Detail oriented with above average organizational skills.
- Excellent customer service skills.
- Excellent written and verbal communication skills.
- Ability to plan, prioritize, and meet deadlines. Core Benefits
& WellnessMedical (including Virtual Care), Dental, and Vision
CoverageEmployee Assistance Program (EAP)Financial
Well-BeingCompetitive pay, Bonus potential, and annual merit
reviews401(k) Plan w/Company MatchHealth Savings Account (HSA) with
HDHP health plansLife InsuranceBasic and Supplemental Life
InsuranceSpouse and Child Life InsuranceTime Off, Disability And
Leave Of AbsencePaid Vacation (Starting at 2 weeks) and 6 Annual
Paid HolidaysLong and Short Term Disability Plans
PIa39e2639dbf6-26289-35773073
Keywords: Paradigm Oral Health, Bellevue , CREDENTIALING & LICENSURE SPECIALIST, Other , Cortland, Nebraska
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