Credentialing Specialist

NationsBenefits

Plantation (FL)

On-site

USD 37,000 - 46,600

Full time

14 days+

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Job summary

A leading healthcare fintech provider is seeking a Credentialing Specialist in Plantation, FL to oversee the credentialing and re-credentialing of providers. The ideal candidate will possess excellent interpersonal skills, attention to detail, and a basic to intermediate knowledge of Excel. Responsibilities include maintaining credentials, processing documents, and ensuring compliance. If you have a degree and experience in healthcare credentialing, apply to transform healthcare for the better.

Qualifications

Healthcare credentialing experience preferred.
Experience with managed care or provider relations.
Experience in a related healthcare field.

Responsibilities

Oversee credentialing and re-credentialing of providers.
Communicate with providers and manage follow-up.
Process and track credentialing documents and data.

Skills

Excellent interpersonal skills

Strong organizational skills

Attention to detail

Ability to multi-task

Basic to intermediate knowledge of Excel

Education

Bachelor’s or Associate’s Degree

Tools

Microsoft Applications

Job description

Overview

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits, flex cards, and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth, improve outcomes, reduce costs, and bring value to their members.

Through our comprehensive suite of innovative supplemental benefits, fintech payment platforms, and member engagement solutions, we help health plans deliver high-quality benefits to their members that address the social determinants of health and improve member health outcomes and satisfaction. Our compliance-focused infrastructure, proprietary technology systems, and premier service delivery model allow our health plan partners to deliver high-quality, value-based care to millions of members. We offer a fulfilling work environment that attracts top talent and encourages all associates to contribute to delivering premier service to internal and external customers alike. Our goal is to transform the healthcare industry for the better! We provide career advancement opportunities from within the organization across multiple locations in the US, South America, and India.

Role

The Credentialing Specialist will be responsible for overseeing the credentialing and re-credentialing of providers that participate in the various NationsBenefits provider networks. This individual will communicate directly with hearing and vision care providers and work collaboratively with the Provider Support, Hearing, and Vision operations teams. This role requires excellent interpersonal skills to communicate effectively. This role also necessitates strong organizational skills, attention to detail and ability to multi-task. Basic to intermediate knowledge of Excel is required.

Tasks and Responsibilities

Maintain records for individual rendering Providers who have been credentialed and/or have applied for credentialing.
Process, record, and track Provider Credentialing documents and data in processing systems.
Effectively manage follow up calls and email.
Monitor faxes, files and other sources of incoming Provider data notifications to ensure that Provider credentialing data is processed in a timely manner.
Communicate with providers to obtain updated documents as needed during and after credentialing process.
Maintain and properly store both electronic and hard copies of credentialing files.
Update provider records and review for completeness and accuracy.
Synthesize and report on data related to credentialing status and attainment.
Draft, send, track and update Provider credentialing approval letters.
Review Provider applications prior to Credentialing Committee meetings to identify possible issues in applications.
Coordinate with Network Accuracy Specialist to reconcile gaps in information on providers between our system and the Credentialing Report.
Take minutes at monthly Credentialing Committee meetings and distribute them for record keeping and approval.
Serve as a liaison with Credentialing Verification Organizations.
Other duties and special projects may be assigned based on business demands.