Credentialing Specialist

Numotion; United States; Remote; Full time

Job summary

Numotion is seeking a Credentialing Specialist responsible for the credentialing and enrollment processes associated with payers, ensuring compliance with regulations. This remote role requires a background in credentialing and insurance, with a focus on providing excellent service to customers and maintaining accurate records.

Benefits

Medical, dental, and vision insurance

401k plan

Life insurance

Short-term and long-term disability

Qualifications

• 2-3 years of related work experience preferred.
• Familiar with Medicare and state Medicaid requirements.
• Ability to manage multiple priorities and work independently.

Responsibilities

• Responsible for timely and accurate credentialing processes.
• Conduct research on updated regulations to ensure compliance.
• Respond to inquiries and maintain a credentialing records database.

Skills

Knowledge of credentialing

Insurance knowledge

Excellent computer skills

Excellent communication skills

Education

Associate’s degree or equivalent

Tools

Microsoft Office Suite

Job description

Credentialing Specialist

Legal

Remote, United States • ID: 14082-128 • Full-Time/Regular

By joining Numotion, you will be a part of the nation's leading provider of Complex Rehabilitation Technology. Numotion is helping thousands of people with individually configured, medically necessary mobility products and services. From manual and powered wheelchairs to disposable medical supplies that serve unique medical and functional needs, we are improving the lives of people with disabilities by enabling them to actively participate in everyday life. Maintaining our standing as the industry leader in CRT comes from having a workforce with a diverse mix of minds, backgrounds and experiences, and we are committed to cultivating an inclusive work environment based on open dialogue, active listening and ongoing definitive actions.

Pay Range: $21.00 - $26.50. It is not typical for an individual to be hired at or near the top of the pay range and compensation decisions are dependent on the facts and circumstances of each case. The specific compensation offered to a candidate may be influenced by a variety of factors including skills, qualifications, experience and location.

JOB PURPOSE:

The Credentialing Specialist is responsible for timely and accurate credentialing and enrollment processes associated with government and/or commercial payers; ensuring compliance with regulatory standards department processes; maintaining accurate records within the licensing and credentialing database.

Key Responsibilities:

· Complete complex credentialing forms accurately and compile requested documentation for packet submission.

· Conduct research on updated state and federal regulations and policies to ensure ongoing compliance to prepare necessary documentation for submittal of Medicare and Medicaid enrollment applications.

· Research, validate, and complete full cycle execution of all necessary business licenses including, but not limited to: City, County, State, Bedding and HME/ DME licenses and specific requirements.

· Maintain and monitor records database with all pertinent credentialing and business requirements to full completion and in a timely manner.

· Meet all deadline submissions with companies, commercial payers, Medicare and state Medicaid agencies.

· Organize and maintain file system and files correspondence and other records.

· Monitor the credentialing shared mailbox daily, prioritize inquiries based on urgency, and respond promptly to ensure timely resolution of questions and issues.

· Consistently follow up with relevant organizations, including making phone calls, to confirm the receipt of submitted documentation and ensure timely processing of documentation.

· Prepare and send completed packets with Medicaid applications, obtaining appropriate signatures, while complying with state regulations and submission requirements.

· Utilize Numotion Leadership Principles to perform the job with integrity, compliance, and values consistent with Numotion’s mission.

· Adhere to employee or customer confidentiality and comply with Numotion’s policies and federal regulations.

· Always provide excellent customer service for all internal and external customers of the operations. Provide solutions for customer concerns and continually focus on customer service as our top priority.

· The above duties and responsibilities are not an all-inclusive list but rather a general representation of the duties and responsibilities associated with this position. The duties and responsibilities will be subject to change based on organizational needs and/or as deemed necessary by management.

REQUIRED QUALIFICATIONS, SKILLS, AND EXPERIENCE:

· Associate’s degree or equivalent from a two-year college or technical school; or two to three years of related work experience and/or training or equivalent combination of education and experience.

· Knowledge of credentialing, insurance and/or insurance knowledge and background

· General knowledge of the DME business model and experience working with commercial payers, Medicare, state Medicaid agencies and license facilities.

· Ability to work in a fast-paced environment, effectively manage multiple priorities and work independently.

· Excellent computer and communication skills.

· Proficient in using technology and in Microsoft Office Suite including but not limited to Excel.

· Able to seek out resources to find solutions.

PREFERRED COMPETENCIES AND QUALIFICATIONS:

· 1-2 years credentialing experience with knowledge of Medicare, state Medicaid’s and state licensure requirements.

· Certified CPCS.

· Credentialing experience within a durable medical equipment environment.

Mental and physical requirements: The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

§ Frequent use of hands, wrists, fingers associated with using computer equipment.

§ Prolonged periods of time working at a desk and/or on a computer.

§ Occasionally move and reach with arms and hands.

§ Ability to lift/move up to 10 pounds.

At Numotion, we offer competitive compensation packages, including medical, dental and vision insurance, short-term and long-term disability, a 401k, and life insurance. Numotion is an equal opportunity employer. We strive for a workplace that reflects the communities we serve and do not tolerate discrimination against our employees, customers, and partners regardless of ethnicity, disability, gender identity, sexual orientation, religion, age, citizenship, marital or veteran status. Numotion is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.