Meds Nexus is looking for candidates on the night shift with experience as Team Lead Credentialing & EDI. The candidate should be enthusiastic and must have a proven work experience in performing all New Client Account Setups, Research and Development activities, ensuring that the credentialing requirements for government and commercial payers are met, Submit and follow-up on submitted credentialing requests to all contracted commercial payers and government agencies, maintain the close working relations experience will be preferred along with Basic IT skills (databases, MS Office, etc.)
Job Responsibilities
3 to 5 years of experience in credentialing department
At least 1 year of experience in a Supervisory Role
Experience in credentialing different specialties with major regular and private payers state-wise
Review the approval and termination of professional provider contracts as they relate to the credentialing process
Ensure accurate and timely information for re-credentialing, data analysis, and directory generation, as well as recommending changes to the credentialing criteria and processes
Maintain all credentialing and re-credentialing policies and processes to ensure that they comply with all applicable regulations
Develop and implement departmental goals and objectives with input from staff members
Develop and implement departmental policies and procedures that guide and support the provision of services
Interact with all customers to ensure prompt and accurate communication as needed to provide the service expected and to meet the goals of the service.
* The salary benchmark is based on the target salaries of market leaders in their relevant sectors. It is intended to serve as a guide to help Premium Members assess open positions and to help in salary negotiations. The salary benchmark is not provided directly by the company, which could be significantly higher or lower.