Credentialing Specialist (Remote)

Credentialing Specialist (Remote)

Medix Healthcare

Remote - USA

$21.00-$25.00 an hour - Full-time

Job Details

Salary

$21.00-$25.00 an hour

Job Type

Full-time - Contract Employment

Contract Duration

For the remainder of the year (Dec 31st 2024)

Qualifications

• 2-3+ Years of Provider Credentialing and/or Enrollment
• Experience with CAQH, CVO and Provider Applications
• Microsoft Suites (Word, Excel) and Abode Proficiency
• High School Diploma or GED

Full Job Description

Are you an experienced Healthcare Credentialer looking for an opportunity with an ever-growing organization? We are currently hiring for "Credentialing Specialist I" to join our strong virtual team on a temporary-contract basis for the remainder of the year! Our organization specializes in offering a wide range of healthcare plans in general - Covering everything from Medical, Dental, Vision and Behavioral Health. Apply to get your name in the mix!

**This position is a temporary-contract expected to last through the end of the year with the possibility of extension dependent on budgeting purposes - If a FTE position opens then the temp employee will get preference**

What we provide to you as a full-time teammate:

We offer a competitive benefits package that is on par with most of the leading healthcare organizations, along with a 401K plan. Apply today if you are interested in getting your name in the mix!

Requirements

Summary: The Credentialing Specialist I performs both credentialing and re-credentialing of provider applications for various areas of ancillary services (Dental, Vision and Auditory). This individual will support a strong FTE team as a Contractor for the remainder of the year with the opportunity of extension depending on budget.

Essential Duties and Responsibilities: Include the following, other duties may be assigned.

As a Credentialing Specialist, you will...

• Facilitate provider onboarding efforts including, but not limited to importing data from CVO into applicable systems.
• Ensuring required documentation is complete and accurate, and that all submitted documentation aligns with industry and organizational standards.
• Review all information for completeness and screen for "red flag" items.
• Forward red flag items for action as necessary to Senior Credentialing Specialists for review.
• Performs timely follow-up with providers on pending applications/information.
• Performs the primary source verification according to the departmental policies and NCQA standards.
• Builds and accurately maintains provider information in various systems.
• Responds to inquiries regarding the status of the provider's application.
• Utilizes organizational templates to communicate with providers about the status of their application with the organization.
• Metrics = 12-30 initial files a week, 25-30 credentials a week

Expectations of Performance: The employee in this role shall be considered to be performing in an acceptable manner when carrying out the Core Values:

• Tech Savvy
• Organizational
• Detail-Oriented
• Reliable

Education and/or Experience:

• 2-3+ Years of Provider Credentialing and/or Enrollment
• Experience with CAQH and Provider Applications
• Microsoft Suites (Word, Excel) and Abode Proficiency
• High School Diploma or GED

Computer Skills: To perform this job successfully, an individual should have knowledge of basic office equipment such as: CAQH, CVO, Provider Application Softwares, Microsoft Suite applications, Abode, computer, internet, email, copy and fax machines, and telephone.

Job Type: Full-time with Overtime Offered (Voluntary)

Pay: $21.00-$25.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• M-F, 7am-7pm EST (Flexible 8.5/hr shifts)

Experience:

• 2-3+ Years of Provider Credentialing and/or Enrollment
• Experience with CAQH and Provider Applications
• Microsoft Suites (Word, Excel) and Abode Proficiency
• High School Diploma or GED